Preventing Health Insurance (makeup beauty tips) Georgia Scams

August 15th, 2010 admin Posted in health |

By Sam Dicosta

One of the reasons that health care costs are so high is the high number of health insurance Georgia scams that go on. Any time there is fraud against the health insurance Georgia companies, they lose money. This unexpected expense then has to be compensated for, which results in higher premiums for members. Therefore, it is to all of our own individual benefits, to do our share to combat and fight health insurance fraud.

There are many ways of trying to cheat on health insurance Georgia plans. One common fraud is for a group to set themselves up as a physicians office, and then file claims against real persons health insurance Georgia policies. This group may steal health insurance Georgia policy identifying information through hacking a companys computer system, or maybe stealing purses and using health insurance Georgia plan member ID cards. This is a fairly straightforward scam, but it may be effective because health insurance Georgia companies typically do not have the means to verify physicians offices to ensure that they are legitimate. Often claims come in electronically, so the health insurance Georgia Companys system verifies the information and the medical codes, and if those appear accurate, then the system automatically sends a payment out.

Other times, real physicians office staff may bill for services that were not really performed. For example, if a patient comes in for an office visit, a dishonest billing personnel staff may also bill for Xrays, or MRIs, and receive payments for those procedures, which were not really given. Although patients do receive Explanation of Benefits (EOB) summaries, which may reflect these payments, many health insurance Georgia plan members are not familiar with how EOBs work, and may not notice payments that were made for services that were not rendered. Usually, a four to eight week turnaround time in claims payment is typical, so a patient may not really recall the date of service, services rendered, or charge amount. Therefore, this type of scam goes unnoticed often. It still can cost the health insurance Georgia provider a lot of money.

A third type of health insurance Georgia fraud is when claims are filed for deceased patients. There is a lot of paperwork that needs to occur when someone passes away. Sometimes informing the health insurance Georgia Company gets overlooked. A dishonest medical office may continue to file claims for medical services rendered using a deceased patients health insurance Georgia plan member identification information. If caught, the billing staff can just state it was a mistake, and reimburse the money, but continue to try again.

All of these scams and fraud have a negative effect on the bottom line for health insurance Georgia companies. As they lose money, they in effect have to raise premiums in order to continue to meet their own financial needs and continue to provide health insurance Georgia benefits to all its plan members. Therefore, we all should work together to catch any fraud or scam that is being done, using our health insurance Georgia member information. Most health insurance Georgia providers have 800 phone numbers where people can call up and alert company representatives if they suspect fraud or any type of scam. Be sure to do this if you ever have the opportunity.

Sam Dicosta shares his knowledge on health insurance that makes you able to find the plans that best fits your needs. If you want to know about health insurance Georgia, health insurance Georgia, group health insurance, affordable health insurance Georgia, Wellpath North Carolina visit www.cvty-healthinsurance.com

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