Medical Insurance Fraud

The last blog I wrote really brought it home to women that if Jane Akre wants to publicly interview and promote a doctor for money, her recommendations can do great harm. If you missed that blog, please read it first.

Over the years it has been said about me that I must be receiving money for recommending Dr. Raz. This of course is ludicrous, but there are those out there who want to throw mud like this because I have stated many times, other women told me they had good experiences by going to him and told me if I was going to survive mesh, I should go and see him for a consult. NO MONEY HAS EVER CHANGED HANDS between women by doing what I do, nor have I been paid by any DOCTOR or hospital.

For over two years I listened to women who went to many doctors all over the country and they told me all the awful things that happened to them by going to other doctors including in my own State of Texas. I wanted to do all I could to get better and knew I had a lot of damage before mesh removal. So that is why I went to him and when things improved I told the world everything. Believe me, I am as broke as ever, so no money is coming in for me to do this. I have no doubt if anyone could prove I made money from this, they would and I do NOT have a criminal record which also says I do not do bad things.

Anyway this blog is to try to help those women who are being screwed out of a settlement because they went to Dr. Walker or the other two doctors cited by AMS. I have been going through my files and when a woman told me about any doctor that I should tell other women NOT to go to, I found this. It was under ‘bad doctor file’ and it was told to me over the phone. Dr. Earle M. Pescatore in Florida.

I am not the only one who is speaking out about Jane Akre and her recommendation of Dr. Christopher Walker. Yes, recommendation because she DOES take money from him to promote him. Call it advertising if she wishes, but it definitely a recommendation. This woman feels the same way.

Of course I am now concerned for sick and injured women who were caught in the trap by reading Akre’s page. Let’s read some of Akre’s article about this doctor.

Urogynecologist Dr. Walker Talks Mesh Removals and Worst Offenders

Dr. Christopher Walker, urogynecologist

Dr. Christopher Walker is a Urogynecologist located in Orlando, Florida. His practice focuses on urogynecology and female pelvic reconstruction.  His office link is here.  This month he is also a supporter of Mesh News Desk. Supporter?

Mesh News Desk editor, Jane Akre recently interviewed Dr. Walker who has patients from around the world visiting his Orlando facility to undergo mesh revision surgeries. Note the clever wording. ‘Revision’. Everything I have read all over the Internet, says that revision means not all mesh is removed and neither are any anchors.

Currently he is doing about 30 to 40 a month. To make their trip as comfortable as possible, he has assembled a team to take care of flight arrangements, ground transportation and hotel accommodations. He has created an alliance with many surgical centers in an effort to decrease the patient’s bill and make the process of pelvic reconstruction financially feasible. Wow, 30 to 40 a month? That is huge inflated profits even if only 10% put up their case for removal. I hope the IRS and the FBI are taking notes.

Dr. Walker spoke with Mesh News Desk editor, Jane Akre about his practice.

Q: Do you take insurance?

I take insurance. A lot of women do not have insurance and are suffering from complications which need a surgical intervention. We therefore have options for them to help them with their financial burden. My goal is to get them back on their feet and restore their lives. What about the women who DID have insurance and he has his department of criminals who will talk them into putting up their case so that he can inflate the surgery costs and they would get stuck with the bill out of their settlement. IF they get a settlement now because of HIS and Jane Akre’s ACTIONS.

If she is NOT up to something then why is she still advertising him and why would she not give him back his money and removed everything she has written about him?

So what can you do if you got caught up in this as a victim?

Now if you are a woman caught up in this and you know your settlement is gone, first you can contact your lawyer and say you wish to make a deposition and be part of any action taken against these three doctors. If they won’t do it, find a civil lawyer in your State and see if they will file a civil lawsuit for you. Believe me I would do this if I was part of it. A civil lawyer may take a group better than one woman, so if you know others, then get together.

So what constitutes health insurance fraud? You already have proof on my blog link showing this was no ordinary mistake. But read this first.

Examples of Fraud

The Association of Certified Fraud Examiners names popular healthcare fraud schemes, including billing for unnecessary services, over-diagnosing and billing for services not rendered. Each of these instances needlessly charges the patient and brings more revenue to the provider.

In most healthcare facilities, a separate department takes care of the billing to the patient. The employee working in the billing department could inadvertently enter an incorrect billing code, charging the patient for a service he or she did not receive.

This charge could be less or more than the usual price of the service the patient actually received. While this occurrence is unintentional, it should still be brought to the billing department’s attention. Thankfully, more often than not, over-charging is due to simple human error.

Unfortunately, there are instances in which the patient is over-charged on purpose. Take for instance a patient who has had a surgical procedure and is charged for each individual tool and supply used during surgery.

These items are normally charged as one item, which saves the patient money, sort of like buying the combo meal at a restaurant rather than purchasing the burger, fries and drink separately. A facility might unbundle this surgical “combo deal” to receive more money from the patient or insurance provider.

So what can you do? You can report what happened to you and how you were draw in to the lies.

How to Report Medical Billing Fraud

Abusive billing should be brought to the facility’s attention immediately. Go through the normal channels of reporting errors in billing, beginning with the billing department. If you have no success here, request the contact information of the facility’s Chief Financial Officer.

Sometimes, just requesting this information is enough to rattle a billing employee into action, but if not, follow through with the threat of going to the CFO. If you are uncomfortable doing so, contact a medical billing advocate to do this for you – they exist to help you through situations such as this.

If you have experienced a true healthcare provider fraud scheme, contact the fraud investigation bureau of your state. The National Health Care Anti-Fraud Association (NHCAA) lists the different Insurance Fraud Bureaus by state here.

If your physician is involved in the medical billing fraud you are reporting, you should also alert your state’s medical board to report suspicion of unethical or fraudulent practices. The Federation of State Medical Boards lists the nation’s medical boards by state on this page.

If you are a participant in the Affordable Care Act, you can report suspected fraud by calling 1-800-318-2596.

If you are covered by Medicare and your billing statements do not match, first contact the provider for answers. The billing department should try to help you understand anything on your bill that does not make sense to you and correct any billing errors. Report suspected Medicare fraud to 1-800-632-4327.

All too often, it’s necessary to be persistent with the billing department in righting any wrongs on a medical bill. If you are not satisfied after reaching out to the billing department or if any billing issues are left unresolved, enlist the help of a medical billing advocate.

I have been pretty busy with another project but because some women may be feeling very depressed if they went to any of these doctors, I decided to write this and post it today. Don’t sit back feeling sorry for yourself. Do something and try to get justice! I wish you luck.

If I find out more you can bet I will post another blog.

1 Comment

  1. ??

    So sad that women are still being mislead when they are suffering already. We really need to look at the big picture now and see WHO has really benefited from mesh. I’m not just talking about manufacturers and lawyers here….. Has a real live person ever come forward to say they’ve been HELPED by any of the websites in question?


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