Don’t fall for health care related schemes

Scammers may try to trick you to share your private information. At this time of year when many people are re-enrolling in health care coverage, we see that scammers increase their activity, so Univera Healthcare has several tips to help you avoid scammers and stay safe.

“All of us should be vigilant year-round, and even more so in the fall during open enrollment season, and be aware of the many types of health care fraud and scams,” said Kristine Gallivan, CISA, CISM, CDPSE, Director, Cyber Risk & Information Assurance.

“If you aren’t sure whether you’ve being scammed in some way, please check the list shared here,” said Meg Paris, AHFI, Corporate Director – Special Investigations Unit. “If you think you are the victim of health care fraud, call your insurer’s Fraud Hotline for further help, or use the listed resources for the other situations.”

Please be vigilant of the following:

Health/health insurance scams

• Review your health insurer’s Monthly Health Statement and watch for unauthorized charges (including for telemedicine visits – see below).
• Be wary of phone calls from people who claim to be from your Health Plan and ask for your health insurance number or other personal information. Verify these calls by contacting your insurer’s Customer Service Department, by calling the phone number on your member ID card.
• Be wary of unsolicited calls from people offering free testing, medication, equipment or supplies. Typically, these services or items are not needed and are not provided or received, but are billed to your health insurance. 
• The FBI warns that “Health care fraud can be committed by medical providers, patients, and others who intentionally deceive the health care system to receive illegal benefits or payments”

Other telephone, email, and telehealth scams

• Hang up on robocalls - Don’t respond to any questions or press any numbers. Scammers use illegal robocalls to pitch everything from fake medical treatments to saying you won the lottery.
• Scammers specifically target older people on Medicare through “spoof” or robocalls.
• Watch for telemedicine claims fraud - Often fraudulent medical claims tied to member care are submitted on behalf of a medical provider by the scamming company (using real or falsified patient information). Providers should pay close attention to all claims, whether they see the patient in person or via a telehealth visit, to avoid fraud. Additional information is available on HHS.gov.
• Avoid tech fraud - These criminals offer to help with non-existent technology-related issues, such as a compromised email or bank account, a computer virus, or a software license renewal, confusing people who lack technical knowledge. Many victims report being directed to make wire transfers to overseas accounts or purchase large amounts of prepaid cards. Additional information is available on FBI.gov.
• Ignore “out of the blue” texts from people you don’t know, don’t accept “friend” requests from unknown parties, and be skeptical of individuals urging fast action.  

Online, mobile app and third-party vendor scams

• Watch for fake websites, social media accounts, and email addresses claiming to sell medical supplies. When consumers attempt to purchase supplies through these channels, the scammers take the money and never provide the promised supplies.
• Not sure if it is a scam? Check the U.S. Federal Trade Commission website.

This information and much more can be found at the New York State Attorney General’s website as well as the Scams page on the U.S. Federal Trade Commission website.

If you suspect fraud related to your health insurance, contact your health insurer. At Univera Healthcare, you can:

• Call our Fraud Hotline at 1-800-378-8024.
• You may also report possible fraud, waste, and abuse with our convenient online form.
• If you are a Medicare member, you can also contact the Centers for Medicare and Medicaid Services about fraud.
• Please note that ALL fraud, waste, and abuse referrals, whether made online or by phone, are CONFIDENTIAL and can be made ANONYMOUSLY.