As a retiree, your asrTrust health & dental benefits cover the cost of many of your healthcare needs, giving you access to important services that many retirees don’t have. Because your benefits are so generous, it’s important to be aware that sometimes healthcare providers, like dentists, physiotherapists, or others, may try to take advantage of your asrTrust benefits. This can happen through something called provider fraud.
Provider fraud occurs when healthcare providers make false claims for services they didn’t provide or don’t need to provide. By understanding how this happens, you can help protect your asrTrust plan and make sure that every dollar is spent on real needs for members.
What Is Provider Fraud and How Can It Happen to You?
Provider fraud happens when healthcare providers, therapists or dentists charge for services they didn’t provide, or they charge for more than they should. They might recommend unnecessary treatments just to make more money off your plan. When provider fraud happens, it directly decreases the money asrTrust has, and there is less money to pay for your real healthcare needs in the future.
Examples of Provider Fraud
Provider fraud can happen in many ways. Here are some examples:
- Billing for services not given: A dentist or therapist might charge your benefits plan for a treatment you didn’t get.
- Charging more than needed: A massage therapist or hearing audiologist might charge your plan for unnecessary services or more expensive treatments than necessary.
- Splitting coverage between spouses: If one spouse’s coverage runs out, a provider might try to bill both spouses for the same service, splitting the cost to get more money from the plan.
How to Spot Provider Fraud
- Check your bills: Always check the bills or statements you get. Make sure they match the services you actually received.
- Ask questions: If a healthcare provider suggests treatments you don’t understand or don’t seem needed, ask why they’re necessary.
- Look for double charges: If you see the same service listed twice or a bill for something you didn’t get, ask about it.
How to Protect Yourself
- Review your bills: Take a few minutes to check your healthcare provider bills and make sure everything is correct.
- Know what’s covered: Learn about the services your asrTrust plan covers so you can recognize if something is wrong.
- Talk to your benefits provider: If you think something is wrong, contact Greenshield to ask questions and get help.
- Ask for details: Don’t be afraid to ask your doctor or healthcare provider for more information if they suggest extra treatments or tests.
What to Do if You Think There’s Fraud
If you think a healthcare provider is breaking the rules or committing fraud, let Greenshield know right away. They can investigate and work to fix the problem. If you think you are experiencing fraud, chances are others are too.
Conclusion
Fraud takes money away from everyone in the plan, leaving everyone with less. Your asrTrust health benefits are critical for paying for the care you need. By checking your bills, asking questions, and knowing what’s covered, you can help protect yourself and the plan, from fraud. Making sure that the plan is used appropriately is a shared responsibility. If you notice anything that doesn’t seem right, speak up.
For any questions please contact Greenshield at 1-877-266-5494.
