Health Insurance Fraud

17/03/2009

“Massachusetts orthopedic surgeon Harold Goodman routinely gave patients potentially harmful X-rays and steroid injections they didn’t need so he could falsely bill Medicaid. Goodman spent as few as five minutes with each patient, giving one patient 74 X-rays and 112 steroid injections in less than three years. Goodman received six months in prison in 2000.”

This is only one of those crazy cases where people harm others just to get what they want. Physicians, doctors or surgeons cheat and provide unnecessary services to charge greater fees not taking into consideration the ethical and physical consequences of their acts. Excessive and inappropriate examinations are illegal but are difficult to detect because as professionals, people trust and entrust them with their lives without questions. Their degrees and titles demand respect and are granted such without much thought or question. People bank on them because they are, supposedly, experts on that field. But sad to say, medical professionals tend to abuse their influence and power over others especially during this trying times of economic meltdown.

  • Computerized Inclinometry: This procedure gauges joint flexibility and is useful to check a person with motion disability. This can be done once or twice depending on the gravity of the disability but repeated measurements “to assess the patient’s progress” might be deemed inappropriate and incur unnecessary cost.
  • Nerve conduction studies: This can be used to determine the status of ones nerve function when a person has experienced an accident and obtained grave physical injuries. However, this test is used inappropriately by some physicians just so they could bill more to insurance companies and thus get more.
  • Ultrasound: This procedure has many uses but is definitely not appropriate for “diagnosing muscle spasms or inflammation”. Also, patients with back pain do not need to undergo this type of procedure.
  • X-rays: This can be vital for people which have internal organ problems that are hard to diagnose. This examines the condition of the patient but is deemed inappropriate when it is done routinely.

To be able to discern whether or not you are being deceived by your medical practioner or doctor, take the time to check a doctor’s background and feedback from other patients before availing of his services. This will help you choose the right competent, medical professional who will be ethical enough to provide quality service that is attuned with the rate he charges you or your insurance company. If you think you have been cheated by either your physician or insurer, never be afraid to file a complaint so these malpractices will be put to a stop.