The military and healthcare industries both play an critical function in San Antonio’;s economic achievement, but one of the nation’;s foremost names in combating fraud says the dynamic of the nearby economic climate may well make us vulnerable to individuals who get advantage of the method.
“In a community like San Antonio, you have Tricare for your military personnel, you’;ve received Medicare, you have got Medicaid, you have personal insurers,” explained Frederick Lohmann, a director with the National Insurance coverage Crime Bureau.
In 2013, there were 12,444 reported circumstances of fraud in Texas.
Violators usually prey on the vulnerable to cash in on the insurance system.
One particular way they get by, Lohmann says, is to get you in their system, beginning at the clinic.
“Saying ‘hey, in order for your policy to be paid you have to seek remedy at ABC chiropractic center,’; that should be a red flag,” Lohmann mentioned.
“Insurance coverage firms are not going to direct you to a certain healthcare provider for your remedy,” he extra.
In Texas, a single of the most typical types of insurance fraud requires automobile insurance coverage claims right after vehicle accidents.
Normally, violators will get a hold of crash victims to cash in on insurance coverage positive aspects.
“How did they get your data?” Lohmann asked. “That must be the second red flag, how did they find out you had been concerned in an accident?”
He said all they have to do is get you to their doctor and you have become a pawn in their game.
“The total thought is to gin up fraudulent payments for treatment options that by no means materialize.”
The great information is there are organizations like the National Insurance Crime Bureau that operate with law enforcement to uncover the stay away from fraud.
The State of Texas also has a Division of Insurance coverage, which is devoted solely to finding and prosecuting insurance coverage fraud violators.
Of the 3 agents with the Division of Insurance coverage tasked with investigating situations of fraud, one particular is positioned in Bexar County.