Hospital Billing Fraud

into my account? It’s a long story, but to make it short – my sister stole my identity and used my name and SSN to charge up thousands in medical bills. The hospital bills started coming to me after the hospitals located me in my home state. It was a big mess to get sorted out and nearly cost me my good credit. I chose not to press charges against my sister although I did tell the hospitals she was the one who commited the fraud. A few weeks later, I inadvertently recieved in the mail a small ($250) check addressed to her from a very old car accident. There was no way I was going to send her this lttle surprise after what she’d done to me so I put it in my account. The stupid person who told me how to do that ended up telling someone who told my sister (double betrayal) and now she told that person (she doesn’t have my #), to tell me she is pressing charges. Of course I can press charges against her for her far worse crime! However, does she even have a case here?

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Hi! My brother and his ex wife got divorced back in 1999. It was a quick divorce and he now has zero ties to her. He pulled his credit report last month and found that she has been using his Union health insurance for plastic surgery as recent as 2006. There are 4 records on his file that he had me call on to get the patient info and they were all from his exwife. Can he sue her for these? Isnt this insurance fraud and a felony?

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I just read this;

http://www.credentialwatch.org/inv/holistic.shtml

and thought that it seemed to have very little objective criticism and rather was just a belittling flame.
In your own opinion, is this piece just a product of a biased writer (and hence lacking any value), or a valuable contribution to protecting consumers against health care fraud.

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I can not get my psychologist to submit the balance of my office visits to my insurance company, nor can I get her to provide me a receipt for those visits so I can submit them. Neither have I been able to get her to contact the insurance company with a pre-cert or what would be now a post-certification for reimbursement. She tells me its all her bookeepers fault, meanwhile I am due somewhere in the vacinity of $8,000.00 with no cooperation in sight. In fact, now she isn’t even returning my phone calls.
(a side note- these visits came as the result of an acrimonious divorce- and some time ago we discovered that she was charging both me and my ex for my daughters visits- she refunded the ex several thousand dollars) HELP!
Do I have any recourse? She is licensed in the state of Virginia.

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Before you answer, please read this thoroughly. I am a student and Illinois Resident. I have PPO health insurance in Illinois that I pay out of pocket for. $1000 deductible, 100% covered. I go to school in Florida and have employer insurance in FL (ever since Sept 2008), but it’s an HMO. The PPO my job offers has no deductible but is 80/20 coverage, so I opted the HMO.

For the average person, it would make no sense to have 2 policies, but I’m not ordinary. I have many pre-existing conditions (some I was born with), hence the Illinois coverage. In Dec of last year, before my FL insurance kicked in, I had a multitude of issues which caused me to have to use my BCBS of IL in Florida where I’m attending school. Many of those things are at bay now, but for doctor visits, exams, etc to arise other than routine check ups, should I start using my FL HMO insurance and just use my IL insurance for when I visit home during breaks? Or should I just drop my FL insurance altogether? The reason this is an issue is b/c I am afraid I my rates will go up or they drop me if I continue to use my insurance which was meant to be for IL, but I have been using it in another state. Yes they will cover b/c it’s PPO and it falls under the BCBS umbrella, but this is the risk I take.

I will NOT drop my Illinois insurance because I have pre-existing issues that is NOT covered by my FL insurance, so switching isn’t even on option. Plus they keep doing layoffs and my certainty at this job isn’t guaranteed. Furthermore, I keep reading about fraud, this is not my intent. I am just trying not to have my rates rise anymore b/c I am a student and not making much as it is. I am looking for the best coverage because good health care is my primary concern. I am NOT trying to file a double claim with both insurances, and I am NOT trying to collect any money out of this. Things happen like the flu, ER visits, and any other reason to visit the doctor when you are sick or injured.

I have a 2 week window during open enrollment to drop my coverage thru my job. I pay only $20 per paycheck for my FL HMO insurance. So the little amount really isn’t that much to fret over, but I need to know b/c I don’t want my IL insurance to go up or to be denied covereage b/c I have two policies out there. Someone please give me some guidance.

I have called my insurance company on both ends, but I can’t get a straight answer from either. It’s always the “you need to contact the other company for the answer”. So I am running around in circles. I was even told to just find out after I use my FL insurance to see. I’m afraid to take the gamble.

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