March is Fraud Prevention Month and over the past few weeks, several associations and companies have been working to get the message of fraud prevention out to the general public. As the month winds down, I thought I could take one last shot at getting this message out to benefits plan sponsors and their members.
The challenge and motto for fraud prevention month is Fraud: Recognize It, Report It, Stop It.
People can be victims of fraud in many ways. They can have their identity stolen, their banking information compromised, or credit cards stolen—either in real life or online. And similarly, with healthcare and benefits fraud, they can have their health benefits stolen or compromised and their health records corrupted as a result of fraudulent activities.
Plan sponsors can join in the promotion of counter-fraud activities by sharing a few key tips with their members. To help, I’ve compiled a list of do’s and don’ts to share with your members, to help them protect their health benefits. Send these tips out in an email or post them to your Intranet to spread the word.
- Do protect your health card (both your provincial and benefits plan health cards). These are your identity cards and the link to your health records. When someone else uses these without your knowledge, your records will be corrupted, which will affect your insurability.
- Don’t let someone else use your benefits card to obtain services or products. When you do this, these services are recorded in your name and the resulting corruption of your health record may result in eligibility issues when you need services at a later time. Similarly, don’t use someone else’s health card or identification to obtain services.
- Do be vigilant. Watch for others abusing our health plan and report these abuses to HR or to our insurer on their anonymous tip line.
- Do check the receipts and explanation of benefits you receive for products or services. Make sure these accurately reflect what was received/done. If there is a difference, report it.
- Don’t sign your name to blank claims forms. These allow others to use you as a patsy for fraudulent activities.
- Do ask for copies of any forms that you sign.
- Don’t let others use your health spending account. These are your funds.
- Do be suspicious of free services that require your health insurance information. Remember, if it is free, there isn’t any need to share insurance information.
- Do alert your health insurance company of any providers who routinely waive your co-payment or deductible.
Remember the slogan for Fraud Prevention Month:
- Recognize It and be vigilant; be on the lookout for scams that can affect you or your plan.
- Report It to Human Resources, to your benefits carrier or anonymously to the Canadian Health Care Anti-fraud Association.
- Stop It. Take an active part in protecting your public (government) and private healthcare dollars.
Joel Alleyne is executive director of the Canadian Health Care Anti-fraud Association.