More Than Just a DIGITAL SPRING Band-Aid CLEANING. Connie Alarcon
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1 More Than Just a DIGITAL SPRING Band-Aid CLEANING Connie Alarcon
2 Agenda BBB Services Complaints Check BBB Scams Health Care Fraud & Abuse Medical Identity Theft Phone Scams
3 Better Business Bureau BBB Serving Central California & Inland Empire Counties BBB Has Been in Business for Over 100 Years Mission - To be the Leader in Advancing Marketplace Trust
4 BBB Services-Business Profiles
5 BBB Services- Request-A-Quote It s Quick and Easy to Use It s Free Mobile Friendly At Your Leisure
6 BBB Services- Customer Reviews Vetted by BBB Sends the Submission to the Business Uses Data to Help Investigate Businesses
7 BBB Services- Dispute Resolution Mediation Arbitration BBB Auto Line
8 Complaints Can Anyone File a Complaint With BBB? When Will the Complaint be Heard? How Does a Complaint Get Filed?
9 Complaints Complaints We Handle: Disputes that relate to marketplace issues experienced with the services or products a business provides. BBB reserves the right to reject complaints that use abusive or foul language.
10 Complaints Complaints We DON T Handle: Employee/employer disputes Discrimination claims Matters that are/have been litigated/arbitrated Complaints against individuals not engaged in business Issues challenging the validity of local, state, or federal law Complaints against government agencies, including the postal service Matters not related to marketplace issues
11 Complaints Medical Complaints for 2016 Dentists-46 Dental Laboraratories-45 Clinics-42 Physicians & Surgeons - Medical-M.D.-31 Hospitals-22 Hospital & Medical Equipment & Supplies-11
12 Billing issues Complaints Collection issues Customer service Getting passed around Can t get ahold of someone
13 Top Complaints for 2016 Online Retailer Auto Dealers New Cars Auto Repair & Service Clothing- Retail Auto Dealers Used Cars
14 Check BBB.org Before You Buy
15 Scams What is a Scam? What Generation is More Likely to be Scammed?
16 8,000 7,000 6,000 5,000 4,000 3,000 2,000 1,000 0 Top Scams of 2016 Scams 1-5 Tax Scams Debt Collections Sweepstakes Online Purchases Employment
17 1,600 1,400 1,200 1, Government Grant Top Scams of 2016 Tech Support Scams 5-10 Advance Fee Loan Fake Check/Money Order Phishing
18
19 Scam Tracker
20 Scam Tracker
21 Health Care Fraud & Abuse Health Care Fraud and Abuse Effects Everyone The majority of health care fraud is committed by a very small minority of dishonest health care providers
22 Health Care Fraud & Abuse Fraud: An intentional deception or misrepresentation of fact that can result in unauthorized benefit or payment. Abuse: Actions that are improper, inappropriate, outside acceptable standards of professional conduct or medically unnecessary.
23 Health Care Fraud Submitting claims for services not provided or used Misrepresenting dates, frequency, duration or description of services rendered Falsifying claims or medical records Falsifying eligibility Billing for services at a higher level than provided or necessary Failing to disclose coverage under other health insurance
24 Health Care Abuse A pattern of waiving cost-shares or deductibles Failure to maintain adequate medical or financial records Improper billing practices A pattern of claims for services not medically necessary Refusal to furnish or allow access to medical records
25 Health Care Fraud & Abuse Do protect your Medicare number and your Social Security Number. Do remember that nothing is ever "free." Don't accept offers of money or gifts for free medical care. Do ask questions. You have a right to know everything about your medical care including the costs billed to Medicare. Prevention Do use a calendar to record all of your doctor's appointments and what tests or X-rays you get. Then check your Medicare statements carefully to make sure you got each service listed and that all the details are correct. If you spend time in a hospital, make sure the admission date, discharge date, and diagnosis on your bill are correct. Do educate yourself about Medicare. Know your rights and know what a provider can and can't bill to Medicare.
26 Health Care Fraud & Abuse Do be wary of providers who tell you that the item or service isn't usually covered, but they "know how to bill Medicare" so Medicare will pay. Do make sure you understand how a plan works before you join. Prevention Do always check your pills before you leave the pharmacy to be sure you got the correct medication, including whether it's a brand or generic and the full amount. If you don t get your full prescription, report the problem to the pharmacist. Do report suspected instances of fraud.
27 Health Care Fraud & Abuse Don't allow anyone, except your doctor or other Medicare providers, to review your medical records or recommend services. Prevention Don't contact your doctor to request a service that you don't need. Don't be influenced by certain media advertising about your health.
28 Health Care Fraud & Abuse Prevention Don t let anyone persuade you to see a Doctor for care or services you don t need. Don't accept medical supplies from a door-to-door salesman. If someone comes to your door claiming to be from Medicare or Medicaid, remember that Medicare and Medicaid don't send representatives to your home to sell products or services. Don't give your Medicare card, Medicare number, Social Security card, or Social Security Number to anyone except your doctor or other authorized Medicare provider.
29 Health Care Fraud & Abuse Contact your insurance Reporting Contact the State Insurance Fraud Bureau File a complaint with the State Medical Boards Report it to the Office of Inspector General Contact CA-Senior Medicare Patrol:
30 Medical Identity Theft A thief may use your name or health insurance numbers to see a doctor, get prescription drugs, file claims with your insurance provider, or get other care. If the thief s health information is mixed with yours, your treatment, insurance and payment records, and credit report may be affected.
31 Medical Identity Theft Detecting Medical Identity Theft A bill for medical services you didn t receive A call from a debt collector about a medical debt you don t owe Medical collection notices on your credit report that you don t recognize A notice from your health plan saying you reached your benefit limit A denial of insurance because your medical records show a condition you don t have
32 Medical Identity Theft Correcting Mistakes in Your Medical Records Get Copies of Your Medical Records Get an Accounting of Disclosures The accounting includes details about: -what medical information the provider sent -when it sent the information -who got the information -why the information was sent Ask for Corrections
33 Medical Identity Theft How to Correct Errors in Your Medical Records Contact each health care provider and ask for copies of your medical records. Check your state s health privacy laws. Complete the request form and pay any fees required to get copies of your records. If the provider refuses to provide your records within 30 days of your written request, you may complain to the U.S. Dept. of Health & Human Services Office for Civil Rights. Review your medical records and report any errors to your health care provider. Write to your health care provider to report mistakes in your medical records. Include a copy of the medical record showing the mistake. Explain why this is a mistake and how to correct it. Include a copy of your police report or Identity Theft Report. Send the letter by certified mail and ask for a return receipt.
34 Medical Identity Theft How to Correct Errors in Your Medical Records Cont. Notify your health insurer and all three credit reporting companies. Send your FTC report of Identity Theft to your health insurer s fraud department and the three nationwide credit reporting companies. Order copies of your credit reports if you haven t already. Consider placing a fraud alert or security freeze on your credit files. Update your files. Record the dates you made calls or sent letters. Keep copies of letters in your files.
35 Phone Scams
36 Phone Scams Can you hear me? Phishing for a yes response Can use your recorded yes response to extort you out of money If you fight the charges they produce the recording as proof
37 Phone Scams EECU Targeting members and non-members Problems with their account Call and give up their card number or personal information
38 Grandparents Scam Phone Scams IRS now calling Don t pay over the phone Beware of unfamiliar numbers Phishing for personal info
39 Review BBB Services Complaints Check BBB Health Care Fraud & Abuse Medical Identity Theft Phone Scams Scams
40 Questions?
41 THANK YOU!
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