Over the course of investigating false insurance claims and insurance frauds, we
have come to a simple conclusion; scammers will always keep coming up with new
ways to defraud insurance companies. This fact is none more so evident that in
medical insurance frauds.
Medical insurance fraud makes up a formidable chunk of the
$80 billion insurance fraud losses in America. The worst part is that the
policy holders aren’t the only ones trying to cheat their way towards a little
extra money or treatment. The medical professionals are just as equally
involves in the scams as the policy holders are. The latest scam making the
rounds in hospitals and clinics across the nation is the “out of network” scam.
Out of Network
Creativity of medical professionals could be admired,
regarding this scam, if it wasn’t so dishonest. The out of network medical scam
allows clinics and hospitals an excuse to charge patients obscene amounts of
money for regular medical procedures and medications. The shocking thing is
that this practice isn’t exactly illegal, and many medical professionals are
taking advantage of it.
The Scam
When you visit an insurance networked clinic, for a routine
checkup or emergency situation, you will have to submit some paperwork. Most
people don’t read the documents and sign them anyway, which leaves them
vulnerable to this scam. After you leave the clinic, you will receive a large
bill for the medical services of a doctor that you didn’t even know existed.
Sometimes your doctor will call someone in for a
consultation or review your medical case, these out of network medical
professionals take advantage of the situation and charge huge amounts of money
for their “services” that you don’t even know that you have received.
Popularity
This scam is becoming more and more popular because of its
simplicity and ease at which it allows medical professionals to siphon off
money from patients and insurance companies. But the popularity of the scam has
also attracted the attention of the authorities to the scam and there are some
actions being taken to resolve this loop hole in medical insurance policies.
To make sure that you don’t fall prey to such a scam, you
should read the paperwork that you sign. And when you require the services of
an insurance fraud investigator, you should remember who to
call. We can help uncover the truth in the matter and make sure that we
gather evidence that can be used in the court of law.
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