insurance fraud.

Discussion in 'Law and Justice System' started by 90K, Dec 20, 2006.

  1. 90K
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    Anybody had experience dealing with possible medical insurance fraud? I’m referring to a situation of somebody passing away and certain medical offices filing bogus claims. I ask this because my mother passed away last summer and I received 2 letters from her insurance company stating she would be receiving outpatient treatment yesterday. Well I called the insurance company and they knew of my communication since my mothers passing with them throughout the summer. Anyways the insurance company has 2 claims submitted via internet. I suspect if this is true the insurance company wants to keep me calm and quiet as to prevent a lawsuit. I want the insurance company to find these individuals involved and hang’em high because this is wrong. I’m waiting for more information from the insurance company so I guess I’ll see the outcome???
     
  2. Hobbit
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    Don't go jumping the gun immediately. There could have been a clerical error (maybe there's a living patient who has your mom's name and they got the records mixed up). Look into it, but wait until you have proof before going on a righteous rampage.
     
  3. 90K
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    Yeah I've given it thought, I guess my views are my first notifying the insurance company and allowing them to take the action on there end. And if it is like many doctors offices they file bills and claims really late and IMHO these practices should stop and be required to be run within like 90 days vise say over 6 months. I'm just the point person to make sure everything is functioning correctly. I can say having had prior communications with the insurance company I know the paperwork so I was alarmed because of the wording. So we'll see but if it is a fraud case I want to make sure I'm protected and I get my point across since it is effecting me too. But other than that I will file it as lesson number #### learned.;)
     

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