Medical Scams [4-23]

Hendricks Community Hospital strives to serve Hendricks and our surrounding communities. To inform our area patrons, we will be publishing topics in our area newspapers about the services and specialties we offer at our local level. Various topics will be covered throughout the next several months to ensure our community is provided with the best knowledge in making their healthcare choices. Our goal is that you enjoy reading more about the services we provide and feel more confident in your decision-making. 

Protecting patrons from falling victim to medical scams

By Kennedy Tesch

Medical scams can be disguised in several different forms but usually involve a company, group or individual providing a good or service that is likely unnecessary and charging the individual or his/her insurance company for the cost of that good or service.

Examples may include a company calling an individual stating that his or her doctor or primary care provider ordered a piece of equipment such as a brace, monitoring device, or incontinence product and getting information on where to send that product. The scammer will then usually call or fax the clinic looking for a signature on an order so they can bill Medicare or another insurance provider. Scammers have also tried to have clinic providers sign an order for a continuous glucose monitor for a diabetic when neither the patient nor the provider requested the device.

Medical scams are a concern because they result in excessive costs to Medicare and other public health entities such as Medicaid. When costs increase these programs are not able to provide necessary services to their beneficiaries. In addition, when healthcare costs increase, taxpayers are affected as the cost to fund these programs also increases.

Often time victims of medical scams are the elderly. Scammers typically will obtain a name or Medicare number or even will access a database of this information and try to provide unnecessary services. You may be contacted by phone, mail, email, or even direct salespersons to provide you a service that you likely do not need or is not medically necessary. While the elderly are often the victims of these scams, they can occur to anyone. 

What do you do if you’ve been a victim of a medical scam?

First, you should never provide your Medicare number or social security number to anyone you do not trust. Your doctor or primary care provider should not order you a good or service without notifying you first. Therefore, do not believe that someone is acting in your best interest if they are contacting you by phone or mail to push a product or service.

If you have been a victim of a medical scam, you have several reporting options. First, if you are unsure if you need a product or service, you can contact your primary care provider to see if the product or service is medically necessary. You can then report fraud by phone at 1-800-447-8477 or on the CMS website: https://www.cms.gov/About-CMS/Components/CPI/CPIReportingFraud

According to our HCHA provider, Kathryn Christensen, DNP, NP-C, fraud can occur in many ways and the healthcare system is not immune to fraudulent activity. Christensen wants to remind patients to keep their private information to themselves and not to share their medical information with anyone they do not know.

“I would recommend patients always be cautious and keep in mind the statement - if it sounds too good to be true, it probably is,” said Christensen. “Never provide your medical information to someone you do not know.”

In addition, the clinic team at Hendricks Community Hospital Association will not order goods or services without discussing it with you first. If someone claims to be working on the behalf of the clinic or your medical providers, feel free to question them.