Protect yourself against health care fraud

Identity theft and Social Security card

About 2.3 million Americans spent an average of 200 hours and $13,500 to resolve medical ID theft cases in 2014.

Imagine someone offering you the chance to get cutting-edge genetic tests for cancer and other serious diseases at no cost to you. For just a few hours of your time, you walk away with peace of mind and a $50 Walmart gift card.

If you’re thinking it sounds too good to be true, you’re probably right.

A large group of unsuspecting Central Texans recently fell victim to this scam. When reporters began investigating the scam, they found the “clinics” boarded up and the saliva samples discarded in a shed.

Like workers’ comp fraud, health care fraud comes in many forms. In some cases, perpetrators bill for services they never provided. In other cases, they overbill for services or provide services patients don’t need. In all cases, the costs trickle down to consumers in the form of higher premiums.

You can protect yourself from health care fraud by following these simple tips:

  • Guard your health insurance information. More than 2 million Americans fall victim to health care identity theft every year. Protect yourself by guarding your health care information the same way you guard your Social Security number, your credit card numbers and your internet passwords. Never give your medical ID card information to a stranger on the phone, in an email or on a website.
  • Review your statements. Review your bills and explanation of benefits to make sure you and your health plan were only charged for services you received. If you see errors, contact you plan’s customer service center or the provider.
  • Ask questions. Ask questions to make sure the treatment your doctor recommends is necessary. Be skeptical if a doctor recommends a new, unusual or experimental procedure.
  • Remember that nothing is free. Don’t accept offers of money or gifts in exchange for your medical ID or other personal information. While many research studies are legitimate, they should never ask for your medical ID or submit claims to your health plan.
  • Report your suspicions. If you suspect someone is trying to lure you into a health care scam, contact your plan’s customer service center, your employer’s human resources department or the Texas Department of Insurance fraud line at (800) 252-3439.

For more information on medical ID theft, visit the Texas Department of Insurance fraud unit online.

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