The FBI estimates that health care fraud siphons off $80 billion a year.
“Imagine the impact an additional $80 billion could have on our nation’s health care system if used for patient care, medical equipment, prescription drugs, or coverage for the uninsured,” said Flora Allen, Corporate Director of Special Investigations for Univera Healthcare and its Rochester based parent health plan.
The federal government dedicates substantial resources for fraud prevention and recovery. Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius report that in 2012, those efforts resulted in a record $4.2 billion in recovered taxpayer dollars.
“Our health plan’s aggressive pursuit of cheaters also produced substantial results in 2012,” said Allen. “Our Special Investigations Unit prevented or recovered $4.6 million in fraudulent claims, or about five dollars for every dollar we invest in fraud prevention.”
Univera Healthcare, like all major health insurers, works closely with law enforcement and regulatory agencies such as the Medicaid Fraud Control Unit, the U.S. Attorney’s office, the FBI and local district attorneys to identify abuses, recover funds and aid in prosecution.
“Members need to be just as concerned about health care fraud as their insurer, since it’s their premium dollars at stake,” said Allen. She offers some common sense tips: · If you’re shopping for health insurance for the first time, you may not be familiar with all of the companies soliciting your business. Don’t provide personal information to anyone unless you’ve confirmed that the insurance company with whom you’re speaking or emailing is legitimate and licensed to do business in your state. Always request copies of policies and applications to verify your coverage. And follow-up by contacting the insurer to verify your application has been processed, and your premium payment was received.
· If you already have health insurance coverage, treat your member ID card as you would your driver’s license or credit card: Keep your ID number secret. If crooks can steal your ID number, they can involve you in scams, or steal your medical identity.
· If you suspect health insurance fraud, call the Customer Service number on your health insurance ID card, or call the New York Attorney General Consumer Frauds and Protection Bureau’s Consumer Helpline at (800) 771-7755.
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“Imagine the impact an additional $80 billion could have on our nation’s health care system if used for patient care, medical equipment, prescription drugs, or coverage for the uninsured,” said Flora Allen, Corporate Director of Special Investigations for Univera Healthcare and its Rochester based parent health plan.
The federal government dedicates substantial resources for fraud prevention and recovery. Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius report that in 2012, those efforts resulted in a record $4.2 billion in recovered taxpayer dollars.
“Our health plan’s aggressive pursuit of cheaters also produced substantial results in 2012,” said Allen. “Our Special Investigations Unit prevented or recovered $4.6 million in fraudulent claims, or about five dollars for every dollar we invest in fraud prevention.”
Univera Healthcare, like all major health insurers, works closely with law enforcement and regulatory agencies such as the Medicaid Fraud Control Unit, the U.S. Attorney’s office, the FBI and local district attorneys to identify abuses, recover funds and aid in prosecution.
“Members need to be just as concerned about health care fraud as their insurer, since it’s their premium dollars at stake,” said Allen. She offers some common sense tips: · If you’re shopping for health insurance for the first time, you may not be familiar with all of the companies soliciting your business. Don’t provide personal information to anyone unless you’ve confirmed that the insurance company with whom you’re speaking or emailing is legitimate and licensed to do business in your state. Always request copies of policies and applications to verify your coverage. And follow-up by contacting the insurer to verify your application has been processed, and your premium payment was received.
· If you already have health insurance coverage, treat your member ID card as you would your driver’s license or credit card: Keep your ID number secret. If crooks can steal your ID number, they can involve you in scams, or steal your medical identity.
· If you suspect health insurance fraud, call the Customer Service number on your health insurance ID card, or call the New York Attorney General Consumer Frauds and Protection Bureau’s Consumer Helpline at (800) 771-7755.
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