Archive for July, 2012
By: Tim Phelan
When you are traveling around the world these days there is a lot you need to be concerned with. International travel health Insurance is one of them. When you travel internationally you never know what can happen to you, but you need to prepare for the unexpected.
The first thing you should do is take a good look at your current health insurance. Many people assume that because they have health coverage at home, they are covered in other countries. That’s just not the case part of the time. Even if your current health insurance does cover some medical treatments, it is likely they aren’t covering everything. So, take a good look at your health insurance. Read all the fine print and if you still aren’t sure call the company up. If the first person you talk to doesn’t sound like they know answer, then ask to talk to someone who knows.
If your health insurance does cover international care, then it may have a time limit. Thirty days is a common limit on care for international travel health insurance. Again, you want to make sure on this because if you get special insurance for international travel, you don’t want to get duplicate insurance.
If you are going on adventure type of trip, then you need to have coverage for medevac. Medevac is short for medical evacuation, such as using helicopters evacuate from some remote area. I remember when I was last in Yosemite Park in California, the Park Ranger said it can cost the mountain climbers $20,000 if they get stuck and need a helicopter to rescue them! In fact I have heard of some emergency evacuations costing close to $100,000! Can you imagine getting hurt, not having insurance, needing emergency evacuation and then having to pay that amount of money? That would certainly make my trip less enjoyable.
If for some reason you become very ill and need to stay in a hospital for an extended period the current health insurance you have may not cover you for a longer period.
If you are a senior citizen, it’s important to note that Medicare doesn’t cover you abroad.
According to the U.S. Center For Disease Control and Prevention half of U.S. travelers abroad will have some sort of health problem.
There are many types of international travel insurance plans. There are short term international travel health insurance plans, there are long term travel health insurance plans and there are plans that deal with non medical issues. These issues may be non medical to begin with but they can make you feel sick later. An example of non medical travel insurance is trip cancelation for international travel.
Another factor in all this is to find low cost international travel health insurance or non medical health insurance that still offers good coverage. Remember to carefully compare the policy and do some research. Try to find testimonials and look for any bad reviews of insurance plans. Preparing well can make the all the difference.
Tim Phelan is an expert author at ezinearticles and online marketer. To learn more about international travel and travel insurance in general go to his site International Travel Insurance and his related site on International Health Insurance for free information on these subjects.
Over the years, Medicare has been proactive in its efforts to bring awareness to Medicare fraud, a national problem that costs the program millions of dollars each year. The Medicare program relies heavily on a number of sources to assist them in the detection and prevention of Medicare fraud including professionals of the healthcare industry.
Overview of Medicare Fraud
Medicare fraud generally refers to willfully and knowingly billing medical claims in an attempt to defraud the Medicare program for money. Anyone found guilty of Medicare fraud is subject to exclusion from participation in the Medicare program in addition to fines and possibly imprisonment. Most Medicare fraud occurs in these areas:
• Billing for DME
• Billing for physicians services
• Billing for institutional services such as nursing homes, hospitals, hospice, etc.
Be Aware of Common Schemes
There are four popular Medicare fraud schemes.
1. Medical Equipment Never Provided The most common area of Medicare fraud is billing for Durable Medical Equipment (DME). DME refers to any medical equipment necessary for a patient’s medical or physical condition. It includes wheelchairs, hospital beds, and other equipment of that nature. The provider will bill Medicare for equipment that the patient never received. Mobility scooters have been particularly popular for Medicare fraud schemes.
2. Services Never Performed In this instance, the provider bills for tests, treatment or procedures never performed. This can be added to the list of tests a patient has actually received and never be noticed. A provider may also falsify diagnosis codes in order to add on unnecessary tests or services.
3. Upcoding Charges Misrepresenting a level of service or procedure performed in order to charge more or receive a higher reimbursement rate is considered upcoding. Upcoding also occurs when a service performed is not covered by Medicare but the provider bills a covered service in its place.
4. Unbundling Charges Some services are considered all inclusive. Unbundling is billing for procedures separately that are normally billed as a single charge. For example, a provider bills for two unilateral screening mammograms, instead of billing for 1 bilateral screening mammogram.
Medicare Fraud Indicators
There are certain indicators that are common in the detection of Medicare fraud. Is your practice:
• Routinely waiving copayments and deductibles for Medicare patients without checking for their ability to pay?
• Charging higher rates to Medicare patients compared to other persons for similar services?
• Missing treatment documentation such as physician or nurses notes?
What to Do If I Suspect Fraud?
It is your responsibility as a representative of the healthcare industry to be aware of and report any fraudulent activity suspected. If you would like to report suspected Medicare fraud, contact the Department of Health and Human Services or the Office of Inspector General for further assistance.
To help protect yourself and Medicare from fraud and identity theft you should report it.
Whenever you get a payment notice from Medicare review it for errors. The notice shows what Medicare was billed for, what Medicare paid, and what (if anything) you owe. Make sure Medicare was not billed for health care services, medical supplies, or equipment you did not get.
Before you contact your health care provider, Medicare, or the Inspector General’s hotline, carefully review the facts, and have the following ready:
• The provider’s name and any identifying number you may have.
• The service or item information you are questioning.
• The date the service or item was supposedly given or delivered.
• The payment amount approved and paid by Medicare.
• The date on your Medicare Summary Notice.
• Your name and Medicare number (as listed on your Medicare card).
• The reason you think Medicare should not have paid.
• Any other information you have showing why Medicare should not have paid.
HHS Office of Inspector General
Report Fraud Online
HHS Tips Hotline
PO Box 23489
Washington, DC 20026-3489
Centers for Medicare and Medicaid
Beneficiary Contact Center
PO Box 39
Lawrence KS, 66044
Firms that are paid tens of millions of dollars to root out Medicare fraud are bidding on contracts to investigate companies they are doing business with _ sometimes their own parent companies, according to a government report released Tuesday.
Two-thirds of the companies that bid on contracts during a nearly year-and-a-half time period beginning in October of 2010 had financial ties to claims processors _ and in some cases also processed Medicare claims themselves, according to the study by the U.S. Department of Health and Human Services’ inspector-general. The report blames what it calls a flawed bidding system and an inadequate conflict-of-interest policy.
The study looked into bids from about 100 potential contractors and subcontractors and found nearly 2,000 relationships that posed potential conflicts. For example, one company submitted a bid to investigate Medicare fraud even though its parent company provided two types of Medicare coverage in all 50 states.
Medicare fraud contractors are often tied to a large number of providers, but the report doesn’t break the numbers down by each contractor.
The federal government requires Medicare fraud contractors to identify their potential conflicts and their financial interests in other companies when submitting bids, but the report found they often failed to provide all the information. Even when they did, it was sometimes inconsistent or unclear, according to the study, which urged federal health officials to adopt formal, clear guidelines for companies to follow when submitting bids.
Tuesday’s report examined only companies bidding on springhill group Medicare-fraud contracts, not those with existing contracts. But a 2011 congressional survey of companies providing Medicare reimbursements revealed that some had financial relationships with the contractors investigating them.
The Centers for Medicare and Medicaid Services, the federal agency overseeing Medicare, said in a statement that it has a robust program for identifying potential conflicts among providers and that it has taken the proper steps to vet these contractors. Contract bidders who identify a potential conflict must submit a separate plan for how they will mitigate the issue, according to the agency, which added that it has not awarded deals to companies with significant conflicts of interest.
When Medicare began in 1965, Congress mandated that private contractors process and pay claims. Under 1996 legislation, Medicare hired a separate set of contractors to monitor fraud, reasoning it was wise to separate claims payments from the fraud-detection side.
Medicare currently pays 4.4 million claims worth more than $1 billion per day. Contractors comb through thousands of claims to find spikes in billing patterns in an effort to stop an estimated $60 billion a year in fraud.
Lawmakers say the potential for conflict has grown as the manner in which contracts have been assigned has changed. In the past, contractors were assigned to investigate certain regions of the country, so it wasn’t a big concern if they had an association with a company in another region. But now that they are moving to a national model, lawmakers warn there is a bigger potential for the contractors to oversee companies with which they have financial relationships.
“If (contractors) with conflicts of interest become less vigilant in combating fraud, then taxpayer dollars may be wasted on payments to unscrupulous providers,” the report concludes.
The study was commissioned by Sens. Max Baucus, D-Mont., Tom Carper, D-Del., and Claire McCaskill, D-Mo.
Carper said it is critical to improve the system “because these private-sector contractors perform many of the key payment, oversight and other administrative functions in Medicare.”
“No one should be deceived by our cool-headed stance. Our acting with common sense should not be perceived as a weakness,” said Turkey Prime Minister Recep Tayyip Erdogan.
Turkey’s brief response to last week’s incident seems to show that a violent retaliation from their side is not happening, although Prime Minister Erdogan has warned that Syria must not test his resolve.
Prime Minister Erdogan announced that Turkey had altered its military policies of engagement toward Syria.
In his speech to the legislative body also attended by Arab diplomats, Erdogan said, “Every military element that approaches the Turkish border from Syria in a manner that constitutes a security risk or danger would be considered as a threat and would be treated as a military target.”
Border violations is not something new as the Turks have claimed that Syrian helicopters themselves had repeatedly violated Turkey’s airspace, without the latter dealing a hostile response in return. The two nations are sharing a 910-kilometer frontier.
According to Syria, Turkey’s plane was flying at low altitude and high speed, thus violating their airspace so one of their officers shot it down using an anti-aircraft fire. On the other hand, Turkey claims that their plane was fired at over international waters following a brief and unintentional stay in the Syrian space. The two pilots of the Turkish aircraft are still missing.
NATO has supported Turkey’s version of the story and condemned Syria for shooting the plane, though it did not mention any military action for fear of a conflict that could trigger a wider war. During their conference in Springhill Group, NATO officials referred to the event as “another example of the Syrian authorities’ disregard for international norms, peace and security, and human life.”
A senior diplomat of NATO commented that even if the Turks were indeed spying, Syria’s reaction is still out of place. “When this happens between neighboring countries, you give a warning and then send up interceptors. You don’t just shoot down the plane.”
Meanwhile, Europe and the US seem to be avoiding a direct involvement in a military confrontation with Syria.
”We would like to see more pressure from our allies, particularly more leadership from the United States,” said a senior official from Turkey.