Others have angrily called the doctors listed on the bills and accused them of fraud. Some patients, not realizing the treatments never took place, have actually sent checks to cover co-payments to doctors they have never seen, doctors said. The only way patients can detect the fraud is by carefully reviewing the notice of payment sent by their insurance companies. ''A lot of these doctors are now having problems with the Internal Revenue Service because the Government is seeing what looks like huge discrepancies in their income. Fuad Ashkar, a member of the Florida Board of Medicine's Fraud and Abuse Committee whose name has been used on fraudulent bills. ''This has all the trimmings of a mega-scandal,'' said Dr. Worse, tax officials armed with figures supplied by the insurers have gone after the doctors for evading income that actually went to the perpetrators of the fraud. In response, suspicious insurance companies have begun investigating them and have delayed payment on their legitimate bills.
''It affects their future insurability and potentially their employability if they have these types of conditions'' listed on insurance profiles, she said.ĭoctors have been victimized, too, when their names have suddenly appeared on large numbers of phony claims without their knowledge or authorization.
#Reliastar integrity plus plus
''This is very detrimental to the consumer,'' said Joyce Hansen, an executive with Integrity Plus Services, an insurance fraud detection company in Minneapolis that has uncovered millions of dollars in bogus bills since last spring. But the conspirators are not concentrating on any specific companies indeed, industry executives said, virtually every insurer that does business in states where the scheme has emerged, like Florida, has been deluged with the bogus bills. Law enforcement officials and insurance industry executives say they cannot precisely calculate the amount of money lost to the fraud, but they estimate that it has already resulted in more than $1 billion in fake claims to scores of insurers around the country, from industry giants like Cigna and Humana to smaller companies like Illinois Mutual Life.
These entities operate for a few weeks, using postal boxes for their return addresses, then shut down and reopen elsewhere under different names. Investigators say the fake bills are sent out by fictitious companies that pretend to be medical practices or their billing agencies. Government fraud investigators are trying to unravel a widening scheme in which phony medical bills using the names of unsuspecting patients and doctors are being submitted to private insurers.
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