Healthcare fraud is a form of insurance fraud that elderly people sometimes fall victim to. This is because fraudulent companies might try to get your loved one to sign up under their health care plans, since the elderly generally need more treatment and medication than other age groups do. Alternatively, a staff member at a nursing home or a home health aide might try to take advantage of your loved one and commit healthcare fraud. If either of these situations occurs, you need to detect it early so that you can protect your loved one. Consider the following signs of healthcare fraud to help you keep your loved one safe.
Duplicate Billing for the Same Medical Service
Your loved one should only receive a bill once for a doctor’s appointment, medication, or some other type of medical service. So, duplicate billing could indicate fraud.
Evidence of Inadequate Care
Proper care should be provided for your loved one through their health insurance. If this is not the case, healthcare fraud is something that you should consider as a cause.
Evidence of Incorrect Medication
The incorrect type or administration of medication should not occur if your loved one receives proper treatment.
False Use of Healthcare Information
Your loved one’s healthcare information should not get used for any purpose other than to help your loved one. Also, staff members in a nursing home should not be using this information falsely.
Inappropriate Billing of Services
Just as duplicate billing of services should not happen for your loved one, inappropriate billing of medical services should not happen under normal circumstances. Any inappropriate billing should raise a red flag.
Incorrect Information on Explanation of Benefit Paperwork
All medical information on your loved one’s benefit paperwork should be accurate and up-to-date. If it is not, healthcare fraud might be occurring.
Misrepresentation of Provider, Date, or Location of Services
Any misrepresented information constitutes a red flag. Check to make sure that location, date, and provider information is accurate for your loved one’s medical services.
Problems with the Care Facility
Your loved one’s care facility should be up-to-date and provide the assistance that your loved one needs.
A medical service or company should never waive deductibles. If this occurs, proceed with caution.
Similarly, co-payments for medical services should not be waived.
These are ten of the most common signs of healthcare fraud that your loved one might experience. It is important that you look out for these issues and others. If you think that your loved one experienced healthcare fraud, contact a legal professional to help your loved one.