Professional con men and thieves are taking advantage of the health insurance marketplaces, which open for business on Tuesday, as a backdrop for their schemes to steal money or financial information from unwary Americans.

Over on, I report how fraudsters are already at work, selling phony “Obamacare cards” or using the soon-to-be-opened insurance marketplaces as a pretense to steal credit card numbers.

Healthcare providers can play a part in fraud prevention and make certain they are not indirectly involved in any scams. Here are three tips:

  1. Establish a central “clearinghouse” for information related to healthcare insurance marketplaces, including fraud prevention. Many patients will be overwhelmed by their complexity. Furthermore it is too complex to expect all your staff to be completely knowledgable. There should be one department, such as Patient Financial Services or Patient Access, which is charged with knowing in all things related to marketplaces, including what to do to prevent fraud and how to report it. Part of the education of that department should include viewing this webinar  hosted by the Federal Trade Commission.
  2. Hold a brief orientation for all staff, clinical and back office. While detailed information about the health insurance marketplaces and related fraud should be centralized, there should be some education conducted across the facility for all patient-facing employees. If staff is taught anything, it should be to tell patients that no one working for the provider will ask for money to buy health insurance or health insurance related products. Any staff member learning of a patient who was approached for payment should report that to whatever department the provider has charged with handling health insurance marketplace queries.
  3. Hand out a copy of “Protect Yourself from Fraud in the Health Insurance Marketplace” tip sheet  to every patient. In this concise, single-sheet there is a wealth of advice for patients on how to spot potential fraud and where to call if fraud is suspected.


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