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juliarsantos

How to Spot and Prevent Medical Identity Theft - 1 views

Foxbusiness.com | westhill consulting insurance - While credit card breaches at retailers are grabbing headlines, identity thieves are quietly homing in on an even more lucrative area: health insur...

westhill consulting insurance how to spot and prevent medical identity theft

started by juliarsantos on 28 Aug 14 no follow-up yet
Rose McGowan

Data breach trends for 2015: Credit cards, healthcare records will be vulnerable - 1 views

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    The data breaches of 2014 have yet to fade into memory, and we already have 2015 looming. Experian's 2015 Data Breach Industry Forecast gives us much to anticipate, and I've asked security experts to weigh in with their thoughts for the coming year as well. Experian highlights a number of key factors that will drive or contribute to data breaches in 2015. A few of them aren't surprising: Organizations are focusing too much on external attacks when insiders are a significantly bigger threat, and attackers are likely to go after cloud-based services and data. A few new factors, however, merit your attention. First, there is a looming deadline of October, 2015 for retailers to upgrade to point-of-sale systems capable of processing chip-and-PIN credit cards. As banks and credit card issuers adopt more secure chip-and-PIN cards, and more consumers have them in hand, it will be significantly more difficult to clone cards or perpetrate credit card fraud. That's why Experian expects cybercriminals to increase the volume of attacks early in 2015, to compromise as much as possible while they still can. The third thing that stands out in the Experian report is an increased focus on healthcare breaches. Electronic medical records and the explosion of health or fitness-related wearable devices make sensitive personal health information more vulnerable than ever to being compromised or exposed. The risk of health related data being breached is also a concern voiced by Ken Westin, security analyst with Tripwire. He pointed out that part of the reason that retail breaches have escalated is because cybercriminals have developed the technologies and market for monetizing that data. "The bad news is that other industries can easily become targets once a market develops for the type of data they have. For more info: Westhill Insurance Consulting Data breach trends for 2015: C
Rose McGowan

Westhill Consulting Insurance - How to Avoid Health Care Fraud | Westhill Consulting In... - 0 views

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    Westhill Consulting Insurance - How to Avoid Health Care Fraud Mail-order medications Patients who buy drugs through mail-order companies could be rolling the dice with their health says Dr. Deborah C. Peel, a physician and founder of the nonprofit Patient Privacy Rights. There's a high probability in many cases that these drugs are counterfeit Peel added. "And you don't ever know because the fraudulent tablets look just like the real ones," says Peel. She says ordering from companies that specialize in mail-order sales that are not affiliated with a legitimate insurance company, especially from foreign countries, can be very risky. Not only could the quality be questionable, it could also be illegal. "But people are desperate because we're being so grossly overcharged for medication," she says. Peel says you can lessen costs by buying generic. You can spot it by: the best thing to do is to keep away from buying drugs from foreign or obscure pharmacies. And if you decide to go with the mail-order route, just stay with U.S.-based companies because if it's a U.S. company, you can report the health care fraud to the Food and Drug Administration while if it's a foreign company, there's little that can or will be done. False product claims According to the Federal Trade Commission, millions fall victim each year to false miracle cures. Especially vulnerable are victims of debilitating and potentially deadly illnesses such as cancer, multiple sclerosis, HIV and AIDS. The FTC website says scammers take advantage of people with a grim diagnosis such as cancer and "promote unproven - and potentially dangerous - substances like black salve, essiac tea, or laetrile with claims that the products are both 'natural' and effective." But, say physicians and other experts, simply because something is advertised as "natural" doesn't mean it works. And while a patient is experimenting with bogus treatments, he or she can squander the opportu
Rose McGowan

Westhill Consulting Healthcare - Car Insurance Tips to Help You Buy Smarter - 1 views

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    "Westhill Consulting - Car Insurance Tips to Help You Buy Smarter Car Insurance Tips to Help You Buy Smarter  It doesn't have to be intimidating; buying auto insurance doesn't have to be stressful. There are many options to customize your policy needs base on your budget. If you are knowledgeable with some basic information you can make smarter insurance decisions. These car insurance tips can help you trim down choices and save time and money. * Make sure you're legally covered From state to state, requirements of car insurance vary but one thing is the same virtually everywhere in the U.S. and it is if you drive a car, you're required to have some form of car insurance or proof of financial responsibility. There are more than few factors such as your driving record and insurance history, may affect your policy rates. You may begin here to find the minimum requirements for your state. * Understand your insurance options Car insurance can sometimes be a bit confusing sometimes; it can be complicated to look at because of many choices available to protect you and your car. For you to understand basics, there are nationwide offers such as the following the difference between collision and comprehensive, before you call an agent or get a quote online. * Get at least three quotes It will help if you get quotes from at least three insurance companies you compare price and service options. It is necessary that you request the same coverage from each to get an apples-to-apples comparison. Rates may differ from one company to another. Remember that not because it is the lowest it is the best because the lowest priced insurance may not give you all the coverage you need. Check for every detail, look at price, amount of coverage, benefits and claims services before you make your decision. * Take advantage of discounts This may surprise you, a number of discounts available to lower you for auto insurance rates. An example is if you insure multiple vehicles
Rose McGowan

PROTECT YOURSELF FROM HEALTH INSURANCE SCAMS - 1 views

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    The U.S. health care system has changed significantly since the passage of the Affordable Care Act. The federal law introduced many changes to the insurance space and health care market and helped change the way that people shop for health insurance coverage. With the launch of insurance exchanges, new marketplaces were opened up to consumers, but these exchanges also represented a promising opportunity for scammers that are looking to exploit a person's private information. The U.S. Federal Trade Commission recently issued a warning about the growing prevalence of insurance scams, and there are some things that people can do to protect themselves and their information when shopping for insurance coverage. Be Careful About What You Share Online Many insurance scams seek to collect personal information through fraudulent websites. These sites can be designed to look official, but are merely fronts for criminal activity. Many fraudulent sites attempt to show that they represent an insurance or government agency, offering policies at discounted rates, but the policies that these sites offer are not real and exist only to collect information, such as medical records. Beware of Unsolicited Calls Sometimes, scammers prefer to take a more direct approach and will disguise themselves as insurance agents representing a reputable company or exchange. These people often attempt to call consumers and offer inexpensive insurance policies based on the information that they provide. Insurance exchanges do not randomly contact consumers and organizations promoting coverage through exchanges will never ask for personal information to be shared over the phone. Document Everything Keeping records of all salespeople you may come in contact with, as well as the names of their representative companies, could be valuable if your information is ever compromised. Information can be used for or against you, and collecting information from the agents or organizations trying to sell you
Rose McGowan

Westhill Healthcare Consulting | Massachusetts - N.J. Commissioner Offers Insurance Pur... - 1 views

Making the right insurance choices can have significant impact on the small business owner’s operation costs. With that in mind, New Jersey Department of Banking and Insurance Commi...

Westhill Healthcare Consulting Massachusetts NJ Commissioner Offers Insurance Purchasing Tips for Small Businesses

started by Rose McGowan on 03 Feb 14 no follow-up yet
Rose McGowan

Tips for those waiting to receive proof of insurance coverage - 1 views

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    Information submitted COLUMBUS - Complications with the federal health insurance exchanges have created challenges for some consumers who have not yet received proof of their insurance coverage. As a result, many consumers are unsure if their medical treatments are covered and are unable to provide their proof of coverage. "Since open enrollment began on Oct. 1 the federal exchange has struggled to process applications and enroll consumers in coverage," Ohio Lieutenant Governor and Department of Insurance Director Mary Taylor said. "These delays are making it more difficult and confusing for consumers to use the health insurance plans they have purchased through the federal exchange." If you recently purchased a plan, but still haven't received proof of insurance from your insurance company, Taylor offers these tips. Contact the Company The first thing you should do is contact your insurance company to verify that you do have insurance coverage. Ask your insurance company for proof of coverage, such as an insurance card or identification numbers. Take detailed notes of conversations and include the representatives names, and date and time they took place. Keep copies of written communication you received from your insurance company such as emails or letters. You may need these materials later. You should also verify that you have paid your first premium on time. Some insurers have permitted late payments for coverage that is retroactively effective to Jan. 1. Ask your insurer for their deadline and keep any records that can serve as proof of payment. If you are about to buy coverage from the federal exchange, print any paperwork or confirmations that you receive during the enrollment process. Payment Options
Rose McGowan

Wearable Technology: The Coming Revolution in Healthcare - 2 views

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    Wearable Technology: The Coming Revolution in  Healthcare The year 2014 may well go down as the year of wearable technology. The impact of wearables is already being felt in education, communication, navigating, and entertainment; but perhaps the greatest potential lies in healthcare. Wearable technology has started to revolutionize healthcare by assisting doctors in the operating room and providing real time access to electronic health records. The full potential of wearable technology in healthcare, though, goes well beyond directly assisting doctors. Patients can now continuously monitor their own health. At the 2014 Consumer Electronics Show in Las Vegas, Sony, LG and Garmin introduced devices that track everything from heart rate and blood pressure to a patient's O2 saturation. By 2018, the overall number of wearable devices shipped to consumers is expected to reach 130 million. With such acceptance on the part of the public, wearables are perhaps the perfect application for healthcare.
Rose McGowan

HEALTHCARE FRAUD - 1 views

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    Health care fraud is a type of white-collar crime that involves the filing of dishonest health care claims in order to turn a profit. Fraudulent health care schemes come in many forms. Practitioner schemes include: individuals obtaining subsidized or fully-covered prescription pills that are actually unneeded and then selling them on the black market for a profit; billing by practitioners for care that they never rendered; filing duplicate claims for the same service rendered; altering the dates, description of services, or identities of members or providers; billing for a non-covered service as a covered service; modifying medical records; intentional incorrect reporting of diagnoses or procedures to maximize payment; use of unlicensed staff; accepting or giving kickbacks for member referrals; waiving member co-pays; and prescribing additional or unnecessary treatment. Members can commit health care fraud by providing false information when applying for programs or services, forging or selling prescription drugs, using transportation benefits for non-medical related purposes, and loaning or using another's insurance card. When a health care fraud is perpetrated, the health care provider passes the costs along to its customers. Because of the pervasiveness of health care fraud, statistics now show that 10 cents of every dollar spent on health care goes toward paying for fraudulent health care claims. Congressional legislation requires that health care insurance pay a legitimate claim within 30 days. The Federal Bureau of Investigation, the U.S. Postal Service, and the Office of the Inspector General all are charged with the responsibility of investigating healthcare fraud. However, because of the 30-day rule, these agencies rarely have enough time to perform an adequate investigation before an insurer has to pay.
Rose McGowan

False medical claims - 1 views

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    The scams Phantom treatments. Dishonest medical providers will bill health insurers for expensive treatments, tests or equipment you never received - and for illnesses or injuries you don't even have. Double billing. Unethical providers may double- or triple-bill health insurers for the same treatments, hoping the insurer won't discover the overruns in the big stack of bills. Shoddy care. You might receive shoddy or substandard treatment for real and urgent medical problems. One eye doctor shined pen lights into patients' eyes and said he'd performed cataract surgery. Surgeons have used defective pacemakers and catheters during heart surgeries, which have killed patients or required more surgeries to correct the problems. Unneeded care. You might receive dangerous and even life-threatening treatment you don't need. One surgeon performed heart surgery on patients who didn't need it. Bogus insurers. Insurance agents or brokers sell you low-cost health coverage from fake insurance companies. Then they take your premiums and disappear. You're left without vital health coverage, and don't even know it until you make a claim. Identity theft. Cheaters steal your medical ID number, then use it to bill health programs tens of thousands of dollars for phantom treatment. Crooks steal your health info from dumpsters behind medical clinics, break into doctor offices and steal files, and hack into computer databases containing your records. Rolling labs. Mobile diagnostic labs give needless or fake tests or physical exams to consumers, then bill health insurers for expensive procedures. Runners. A person hired by a medical provider to drum up business trolls through neighborhoods, often low-income areas, enticing people to come to a clinic for tests. These runners will even round up children for unneeded tests and procedures.
Rose McGowan

That's where the money is - 1 views

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    MEDICAL science is hazy about many things, but doctors agree that if a patient is losing pints of blood all over the carpet, it is a good idea to stanch his wounds. The same is true of a health-care system. If crooks are bleeding it of vast quantities of cash, it is time to tighten the safeguards. In America the scale of medical embezzlement is extraordinary. According to Donald Berwick, the ex-boss of Medicare and Medicaid (the public health schemes for the old and poor), America lost between $82 billion and $272 billion in 2011 to medical fraud and abuse (see article). The higher figure is 10% of medical spending and a whopping 1.7% of GDP-as if robbers had made off with the entire output of Tennessee or nearly twice the budget of Britain's National Health Service (NHS). Crooks love American health care for two reasons. First, as Willie Sutton said of banks, it's where the money is-no other country spends nearly as much on pills and procedures. Second, unlike a bank, it is barely guarded. Some scams are simple. Patients claim benefits to which they are not entitled; suppliers charge Medicaid for non-existent services. One doctor was recently accused of fraudulently billing for 1,000 powered wheelchairs, for example. Fancier schemes involve syndicates of health workers and patients. Scammers scour nursing homes for old people willing, for a few hundred dollars, to let pharmacists supply their pills but bill Medicare for much costlier ones. Criminal gangs are switching from cocaine to prescription drugs-the rewards are as juicy, but with less risk of being shot or arrested. One clinic in New York allegedly wrote bogus prescriptions for more than 5m painkillers, which were then sold on the street for $30-90 each. Identity thieves have realised that medical records are more valuable than credit-card numbers.
Rose McGowan

The Challenge of Health Care Fraud - 1 views

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    Consumer Alert: The Impact of Health Care Fraud on You! In 2011, $2.27 trillion was spent on health care and more than four billion health insurance claims were processed in the United States. It is an undisputed reality that some of these health insurance claims are fraudulent. Although they constitute only a small fraction, those fraudulent claims carry a very high price tag. The National Health Care Anti-Fraud Association (NHCAA) estimates that the financial losses due to health care fraud are in the tens of billions of dollars each year. Whether you have employer-sponsored health insurance or you purchase your own insurance policy, health care fraud inevitably translates into higher premiums and out-of-pocket expenses for consumers, as well as reduced benefits or coverage. For employers-private and government alike-health care fraud increases the cost of providing insurance benefits to employees and, in turn, increases the overall cost of doing business. For many Americans, the increased expense resulting from fraud could mean the difference between making health insurance a reality or not. However, financial losses caused by health care fraud are only part of the story. Health care fraud has a human face too. Individual victims of health care fraud are sadly easy to find. These are people who are exploited and subjected to unnecessary or unsafe medical procedures. Or whose medical records are compromised or whose legitimate insurance information is used to submit falsified claims. Don't be fooled into thinking that health care fraud is a victimless crime. There is no doubt that health care fraud can have devastating effects. What Does Health Care Fraud Look Like? The majority of health care fraud is committed by a very small minority of dishonest health care providers. Sadly, the actions of these deceitful few ultimately serve to sully the reputation of perhaps the most trusted and respected members of our society-
Rose McGowan

There Is a Reason We Never Crack Down on Medicare Fraud - 1 views

Did you know there's a government program that gives more than $60 billion a year to felons and voracious, unscrupulous hospitals and doctors? There is: improper health-care payments. In FY 2012, M...

Westhill consulting healthcare insurance There Is a Reason We Never Crack Down on Medicare Fraud

started by Rose McGowan on 08 Dec 14 no follow-up yet
Rose McGowan liked it
Rose McGowan

Fraud watchdog: Health law sign-ups dogged by data discrepancies - 1 views

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    WASHINGTON - The Obama administration has been struggling to clear up data discrepancies that could potentially jeopardize coverage for millions under the health overhaul, the government's health care fraud watchdog reported Tuesday. The Health and Human Services inspector general said the administration was not able to resolve 2.6 million so-called "inconsistencies" out of a total of 2.9 million such problems in the federal insurance exchange from October through December 2013. Of the roughly 330,000 cases that could be straightened out, the administration had only actually resolved about 10,000 during the period of the inspector general's audit. That worked out to less than 1 percent of the total. Several states running their own insurance markets also were having problems clearing up data discrepancies. Most of the issues dealt with citizenship and income information supplied by consumers that conflicted with what the federal government has on record, the report said. It marked the first independent look at a festering behind-the-scenes issue that could turn into another health law headache for the White House. President Barack Obama celebrated 8 million sign-ups as proof that technical problems which initially kept many consumers from enrolling had finally been overcome. It now turns out that some of those problems continued out of sight. The inspector general said the efforts of the administration and states to clear up the discrepancies were complicated by lingering computer issues.
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