Buffalo, NY

Don’t Fall for Health Care Related Schemes

Scammers may try to trick you out of your private information. 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, Cybersecurity Governance, Risk and Compliance.

“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 identification card.
  • Be wary of scammers who pretend to be doctors or represent hospitals that have treated a friend or relative for an illness, and they may demand payment for that treatment.

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.
  • Be aware of phishing emails referencing an illness, which may contain malware (details HERE). Do not open any documents or click links unless you are absolutely sure they are safe.
  • 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 (details HERE).
  • 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 (details HERE).

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.

This information and much more can be found at the New York State Attorney General’s website at https://ag.ny.gov/ as well as the Scams page on the U.S. Federal Trade Commission website here: https://consumer.ftc.gov/scams.

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

Peter Kates, (716) 857-4485

Univera Healthcare is a nonprofit health plan that serves members across the eight counties of Western New York. With more than 500 Buffalo-based employees and a local leadership team, the company is committed to attracting and retaining a diverse workforce to foster innovation and better serve its members. It also encourages employees to engage in their communities by providing paid volunteer time off as one of many benefits. Univera is part of a Rochester-based health insurer that serves more than 1.5 million members across upstate New York. Its mission is to help people live healthier and more secure lives through access to high-quality, affordable health care, and its products and services include cost-saving prescription drug discounts, wellness tracking tools and access to telemedicine. To learn more, visit UniveraHealthcare.com.


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