Are hospitals committing insurance fraud?
I recently had an experience where I had to go to the emergency room due to a diabetic condition. Upon entering the emergency room I informed them that I am a insulin-dependant diabetic and needed insulin because my insulin pump stopped working and was in critical danger. They forced me to have a full cardio workup with blood draws, an EKG, and a chest x-ray. I verbally refused all of the tests and kept asking for insulin. I did not receive insulin and was transported to a cardiac hospital. I fell into diabetic ketoacidosis due to blood sugars over 400 for several hours while they were forcing expensive tests on me and ended up in the ICU for almost 3 days.
I have recently reported this incident to my insurance company’s fraud division and will let them investigate. This experience caused me a lot of confusion and presented me with the following questions:
How many tests do hospitals submit to insurance companies that they never perform?
How many claims do they submit for expensive tests that are either, not required or refused by the patient?
How many patients that have been in situations similar to mine where they are alone and unable to defend themselves that this has this happened to?
Could this be a major contributing cause to skyrocketing health costs?
Should insurance companies conduct random interviews with their insured clients to spot check for fraud?
I have recently reported this incident to my insurance company’s fraud division and will let them investigate. This experience caused me a lot of confusion and presented me with the following questions:
How many tests do hospitals submit to insurance companies that they never perform?
How many claims do they submit for expensive tests that are either, not required or refused by the patient?
How many patients that have been in situations similar to mine where they are alone and unable to defend themselves that this has this happened to?
Could this be a major contributing cause to skyrocketing health costs?
Should insurance companies conduct random interviews with their insured clients to spot check for fraud?
