Seniors Be Wary of the Warning Signs of Medical Identity Theft!


med theftIt’s easier than you think for a thief to use your health insurance to see a doctor, or get prescriptions, even to file false claims with your insurance provider!

Regal encourages you to protect your medical information and insurance statements just like you would credit card information, and to store these items securely so they don’t inadvertently fall into the wrong hands. We advise Seniors to not throw items with medical and/or insurance information in the trash, but to be sure and “shred instead.” You should always check their medical records and insurance records for errors, just like bank statements, both to look for red flags and to be sure to correct any mistakes.

In order to help our clients protect themselves from medical identity theft and insurance fraud we urge family members who are family caregivers responsible for a Senior, or Trustees and Guardians caring for a client or an elderly loved one to develop good safety habits such as:

  •      ~  Reviewing the Explanation of Benefits (EOB) statement or monthly summary as soon as they receive it;
  •      ~  Verifying that the dates, provider, medications or therapies administered are all correct; and
  •      ~  Ascertaining that the claims paid do match up with the diagnosis and services received.

Seniors should know the warning signs of medical identity theft, which include:

  •      ~  Bills for medical services, medications, or therapies and equipment not received;
  •      ~  Debt collectors calling for medical debt not owed;
  •      ~  Collections notices on a credit report that are incorrect;
  •      ~  Health plan notices that benefit limits have been reached when that is clearly false; and
  •      ~  Denial of insurance for a condition the client doesn’t have!

As always, an ounce of prevention is worth a pound of cure, so Seniors should take note of these top tips to help them steer clear of insurance fraudsters and healthcare scams:

  •      ~  Never sign blank insurance claim forms;
  •      ~  Never give blanket permission to a medical provider to bill for services not yet rendered;
  •      ~  Ask medical providers what they charge and what is expected to be paid for out-of-pocket;
  •      ~  Carefully review the insurer’s explanation of any benefits statement inquires;
  •      ~ Give insurance/Medicare identification only to those who have provided you with medical services;
  •      ~  Keep accurate records of all health care appointments and know if your physician ordered medical equipment or therapy for you; and
  •      ~  Beware of salespeople trying to sell you something they claim will be paid for by Medicare or is FREE.

Here are some links for Seniors and their families who need to learn HSA, Healthcare, Long Term Caremore about insurance fraud and medical scams and how to avoid them. The Department of Justice created the Elder Justice Website, a one-stop information website for victims, families, caregivers, prosecutors and practitioners. You can report elder fraud and financial abuse here and find the local Adult Protective Services and Area Agency on Aging. Other resources include: www.ncoa.org/SavvySeniors, www.Stopfraud.gov, and the National Center on Elder Abuse site, www.ncea.aoa.gov.

CONTACT US: Local resources include Regal’s Certified Dementia Practitioners, Geriatric Care Managers, Certified Case Managers, clinicians, and caregivers who are trained to recognize financial exploitation of the elderly. These professionals serve as advocates for Seniors, and after assessment will advise if assistance with managing financial resources is in order, or protection and legal advice is required because financial abuse, fraud, and exploitation may have occurred. Regal can offer assistance in dealing with the agencies and medical professionals who are different pieces of the overall puzzle, and can provide help as needed with managing the patient’s insurance benefits. For more information, contact Regal’s Founder and CEO, Ferial André, RN, CCM, CDP, CAEd, at 561-499-8382 or ferialandre@regalcares.com

This article is not intended as medical or legal advice.