Cover
Cotter Bass
FRAUD PROTECTION
FOR SENIORS
Cotter Bass
Disclaimer
FRAUD PROTECTION FOR SENIORS examines strategies for recognizing and avoiding various types of fraud and provides tips and special tactics designed to keep your family, your savings and investments, and your business safe from con artists and unscrupulous criminals.
This publication is sold with the understanding that neither the author nor the publisher is rendering legal, medical, accounting, or any other professional counseling. The information contained herein is not intended to replace instructions by trained professionals. For advice regarding legal, medical, accounting, or other issues, readers are advised to consult an attorney, physician, accountant, or other appropriate qualified professional.
Trademarks, service marks, product names, businesses names, or named features are assumed to be the property of their respective owners and are used only for reference. There is no implied endorsement.
All rights reserved. No part of this publication may be reproduced in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage or retrieval system, without written permission from the author and publisher.
Copyright © 2018 by Cotter Bass
All Rights Reserved
Cover photo by Pedro Ribeiro Simões and licensed under the Creative
Commons Attribution 2.0 Generic (via Wikimedia Commons)
The author wishes to thank Wikipedia, Wikimedia Commons, the U.S. Congressional Budget Office, the U.S. Federal Trade Commission, the U.S. Department of Health and Human Services, and the U.S. Department of Justice for their valued assistance during the preparation of this manual.
Introduction
FRAUD TARGET: SENIORS
The following tips reveal how you can protect yourself and your family from fraud. Seniors especially should be aware of fraud schemes for the following reasons:
1. Seniors are most likely to have a “nest egg,” own their home, and/or have excellent credit - all of which make them highly attractive to con artists.
2. People who grew up in the 1930s, 1940s, and 1950s were generally raised to be polite and trusting. Con artists exploit these traits, knowing that it is difficult or impossible for these individuals to say “no” or just hang up the telephone.
3. Older Americans are less likely to report a fraud because they don’t know who to report it to, are too ashamed at having been scammed, or don’t know they have been scammed. Elderly victims may not report crimes, for example, because they are concerned that relatives may think the victims no longer have the mental capacity to take care of their own financial affairs.
4. When an elderly victim does report a crime, they often make poor witnesses. Con artists know the effects of age on memory and they are counting on elderly victims not being able to supply enough detailed information to investigators. In addition, the victims’ realization that they have been swindled may take weeks - or more likely, months - after contact with the fraudster. This extended time frame makes it even more difficult to remember details of the fraudulent events.
5. Seniors are usually interested in and susceptible to products promising increased cognitive function, virility, physical conditioning, anti-cancer properties, and so on. In a country where new cures and vaccines for old diseases have given every American hope for a long and fruitful life, it is not so unbelievable that the con artists’ products can do what they claim.
Mountain Christian Center
I. HEALTH INSURANCE FRAUD & HEALTHCARE FRAUD
I. HEALTH INSURANCE FRAUD & HEALTHCARE FRAUD
HEALTH INSURANCE Fraud:
Health Insurance Fraud Is Described As An Intentional Act Of Deceiving, Concealing, Or Misrepresenting Information That Results In Health Care Benefits Being Paid To An Individual Or To A Group.
1. Fraud may be committed either by an insured person or by an insurance provider. Member fraud consists of claims on behalf of ineligible members and/or dependents, alterations on enrollment forms, concealing pre-existing conditions, failure to report other coverage, prescription drug fraud, and failure to disclose claims that were the result of a work-related injury.
2. Provider fraud consists of claims submitted by bogus physicians, billing for services not rendered, billing for higher level of services, diagnosis or treatments that are outside the scope of practice, alterations on claims submissions, and providing services while medical licenses are either suspended or revoked. Independent medical examinations debunk false insurance claims and permit the insurance company or claimant to seek a non-partial medical view for injury-related cases.
3. According to the Coalition Against Insurance Fraud, health insurance fraud depletes taxpayer-funded programs like Medicare and may victimize patients in the hands of certain doctors. Some scams involve double-billing by doctors who charge insurers for treatments that never occurred and surgeons who perform unnecessary surgery.
4. The primary reason that medical fraud is such a prevalent practice is that nearly all of the parties involved find it favorable in some way. Many physicians see it as being necessary to provide quality care for their patients. Many patients, although disapproving of the idea of fraud, are sometimes more willing to accept it when it affects his or her medical care. Program administrators are often lenient regarding the issue of insurance fraud because they want to maximize the services of their providers.
5. The most common perpetrators of healthcare insurance fraud are health care providers. One reason for this is that the historically-prevailing attitude in the medical profession is one of "fidelity to patients." This incentive can lead to
Impressum
Verlag: BookRix GmbH & Co. KG
Tag der Veröffentlichung: 24.06.2019
ISBN: 978-3-7487-0811-7
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