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Medical Fraud is on the Rise

Friday, 19 August 2016 05:14 | Written by
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Following an undercover operation by police, three men, including a doctor, were arrested in Miami for illegally billing an insurance company for patients who never were treated. 

“This goes on all the time,” the individual working undercover as the patient explained. “To be honest, this type of behavior has reached epidemic proportions. It’s happening all over the country and affecting everybody and everything, including insurance rates.”

While there are many types of insurance fraud—ranging from the above example to staged car accidents—there’s a more subtle type of fraud occuring. Failure to divulge prior injuries and repeated claims for the same injury cost insurance companies millions of dollars every year. It also raises the rates as much as the more blatant cases previously mentioned.

For example, one of the nation’s biggest retailers is sued two to five times a day. That’s right—a day! I’m fairly certain many of those people actually suffered some type of injury. Many, however, are viewing the retailor as an easy mark because of its size.

With the help of positive identifiers, we find all the addresses a claimant has reported. Then we can search area hospitals and MRI facilities. These are the most common places for ER treatment and MRI studies ordered by physicians, including chiropractors.

While we don’t obtain actual privacy-protected medical information, we can determine when and where the subject was treated. Then records can be ordered with a release or subpoena. We also can tie these treatment dates to other accidents we found through Department of Motor Vehicle records and other sources.

So don’t settle that claim until you let Inter-Facts level the playing field! Our privacy compliant hospital canvas is the most accurate in the business.

 

Read 3097 times Last modified on Friday, 19 August 2016 05:18
Bill Lamb

William (Bill) Lamb, a licensed Private Detective, began his professional investigation career in the 1980’s in the Military Police, moving into Military Police Investigations within one year.  Following service to his country, Mr. Lamb moved into a management position, always having the thought of returning to some type of investigation work.  In 1995, he accepted a position working for Insurance Investigative Consultants, one of the nation's original investigation firms, providing support to the insurance industry.  William Lamb continues to review every file before it reaches a client's hands.  He also personally handles criminal defense investigations for some of Lake County’s top law firms.

blamb@inter-facts.com

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Inter-Facts Affiliations

NALILogoNational Association of Legal Investigators : Formed in 1967 for legal investigators actively engaged in negligence investigations for the plaintiff and/or criminal defense. 

  

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The National Council of Investigation and Security Services: The National Voice of the Private Investigation & Security Profession  

 

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The National Society of Professional Insurance Investigators : Providing recognition, encouragement, and support to individuals who demonstrate the highest degree of professionalism in conducting insurance investigation.