Understanding Healthcare Fraud of the Elderly

Healthcare fraud is a type of financial abuse that people in nursing homes can experience. This type of fraud can be hard to detect. Your loved one could be experiencing this fraud without realizing it. If you suspect someone in a nursing home is suffering from this type of fraud, continue reading to learn more.

Healthcare Fraud

This type of fraud is a type of fraud that occurs when someone files dishonest or false health care claims so that they can profit from the claims. Elderly people are often the targets of this form of fraud because they are vulnerable and may not closely watch their finances.

Examples of Healthcare Fraud

Here is a list of a few examples of healthcare fraud. If your loved one is in a nursing home and is the victim of any of these issues, they may be experiencing this type of fraud.

  • Charging for healthcare but not providing it
  • Billing for services that haven’t been rendered
  • Bribery
  • Double billing for medical care
  • Medicaid or medicare fraud
  • Over or under medicating your elderly loved one
  • Overcharging for medical care
  • Recommending fraudulent solutions to medical conditions
  • Unbundling

Signs of Healthcare Fraud

Here is a list of the signs of this type of fraud. If your loved one is in a nursing home and you see signs like this, they could be experiencing healthcare fraud.

  • Duplicate billings for the same medical service
  • Evidence of inadequate care
  • Evidence of incorrect type or administration of medication
  • False use of healthcare information
  • Inappropriate billing of services
  • Incorrect information on explanation of benefits paperwork
  • Misrepresenting provider, date, or location of services
  • Problems with the care facility
  • Waiving deductibles
  • Waiving copayments

How To Talk To Your Loved Ones

Talking to your loved ones about this type of fraud can be hard, especially since it is hard to detect. If you are having trouble starting a conversation with your loved one about whether they are experiencing this form of fraud, you can start by asking these questions:

  • Are you receiving all of the care that you need?
  • Are you receiving all of the care that you are being charged for?
  • Has anyone convinced you to make a decision you were unsure about regarding your health?

Getting Help

Have you seen any of the signs of this type of fraud with your loved one in a nursing home? If so, give us a call. We can help answer your questions and make the right decision. You can call us at 203-208-3065.

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