Now, this is something we ask our readers to keep their eyes open for; pumped up medical bills! This latest piece of news takes the cake!
A West Hollywood Doctor recently surrendered to the police for insurance fraud. The amount that the insurance company lost was more than $360,000!
Modus Operandi: As per the article in the Daily News, he "allegedly inflated his invoices by double billing for a hot/cold water unit called Vital Wrap System used to reduce pain and swelling after undergoing surgery.
Instead of filing the device under one Healthcare Common Procedure Coding Systems (HCPCS) code, he used two combined codes, insurance investigators reported in a news release. Insurance department investigators also allege that Schmuel took part in a kickback scheme, allegedly paying to have the Vital Wrap System prescribed to injured workers “despite it not being medically necessary” and paying a “marketer” $100 per unit that was provided by Schmuel and prescribed to injured patients by another medical provider."
What can you do as a patient to avoid being hit by scamsters?
1. Check your medical bill thoroughly for suspicious line items.
2. Ask your doctor/hospital's billing staff to explain unclear items
3. Check your insurance company's EOB (Explanation of Benefits) statement to see if it ties up with the medical bill and if they have rejected any item- that could be worth investigating!
For more details, check out the story @ The Daily News.