Insurance Company Billed in Brain Surgery Fraud

In an article on Fox News, New York-based Group Health Incorporated was billed for 20 brain surgeries, totaling over $300,000. Not a single one of these operations actually took place.

This fraud was kept all in the family, with a man claiming a total of 9 surgeries for himself, with additional surgeries claimed for his wife and two sons.  

How was this pulled off? Well, the key player worked at a medical billing company. As claims came in from other people, he changed the names to his own or his family members. Apparently, three other people were also in on the fraud and have also been charged.

The fraud was initially identified by employees at Group Health Incorporated, who turned over evidence to officials.

Unfortunately, the pattern of fraud in the area of health insurance makes getting your claim harder to get paid. I seem to read more about fraud cases all the time. It means that insurers put more fraud detection in place, at a higher cost, which ends up in higher premiums to you. While I'm not a fan of high-priced insurance, I can't blame the insurers. Seems that many think insurance is a great way to get something for nothing.

I'll be on vacation for the next week or so. No need for travel insurance though; we're just going to see a few local attractions, and hang out with the kids. We did think about an RV to take the "hotel on wheels" approach, but couldn't believe the costs of RV insurance and rental! With the cost of gas, I suspect we won't be the only ones staying close to home.

Monique L. Attinger 

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