Insurance Fraud Continued

PART 2…The reason why I picked Jon smiths age to be 19 for this post is because at 18 all of his treatment ( prescriptions, therapy, counseling, and recovery plan) has to be shared with his parents. At 19 he doesn’t have to share any of it if he chooses not to, leaving the loved ones blind as to whats going on within his recovery. That’s a serious problem with the current treatment protocol. Now he arrives at detox, insurance has paid for his transportation and will now pay 10-15,000 dollars for a 7-14 day stay. Most likely he will only be there 7 days, then they will send him to a 30 day inpatient. The insurance company will be billed for all 14 days, and fly him to the rehab. This is where the REAL billing starts. He comes to rehab completely chemically incompetent, hoping after 30 days he can go back home and resume a clean life. The rehab is betting on him leaving after fifteen days because after fifteen days they can bill the insurance company for the full 30 day stay at an average cost of 40-60,000 dollars. Jon smith represents every single person that has gone through and will go through this cycle. Over the last fifteen years all of them have repeated this cycle 5-10 times until every last nickel of insurance money is GONE. That’s why you have so many people flooding the state systems, but wait…… because the billing just got started. When he arrives, he is sent to a doctor as this epidemic and industry continue to steam roll. The doctors associated with them get less and less reputable. You may have one doctor who handles 5 rehabs in a 10 mile radius. The doctor will prescribe him 3-5 medications at a cost of 150.00 each, but then he may prescribe two or three other things (extras)….acne cream, eye drops, special brace for your arm, ANYTHING they think they can bill for. Each one of these prescriptions will generate numerous pieces of paperwork PER SCRIPT. That doctor will see 10-15 patients a day. He will make 8-10,000 dollars that day and create hundreds of pieces of billing in one day to insurance carriers. This is one doctor in one day and this is going on in thousands of treatment centers and sober homes. The doctors and the rehabs are doing this on purpose. They are blinding the insurance company with so much paperwork that billing is just writing checks. I know there are millions of dollars in checks being sent to to families and they have no clue where or what rehab they need to send them too. This shakedown has been going on strong for 15 years. Here’s a little more fraud just in case this isn’t enough. If Jon Smith decides after 15 days to leave he can sign himself out taking his bag full of meds with him out into the streets of FL, CA and AZ to name a few and what the rehab does is tell him if you want to come back here it has to be within 24 hrs or we can’t take you back. Then they give him the names of three of their satellite rehabs in the area. Jon Smith makes it two days on the streets loses all his meds and calls one of the numbers they gave him… AND THE BILLING PROCESS starts all over again. Remember as he goes through this cycle once or twice, he has now learned how to abuse his insurance as well. Addicts will use this card to not only doctor shop, they’re using them to fly to rehabs all over the country. People who have been through these dysfunctional nightmares more than once learn from the others. A lot are using the excuse to go to rehab just to get away from where they’re at. Most know by now that they’re only making them sicker. If he makes it to a sober living facility, he will share a condo with 10 other addicts, none of them any better. All of them sharing meds with no supervision. They’re also drug trafficking, prostituting, extortion, rape and any other things you can think of. The person who owns the place is charging insurance 3,500 dollars a week per person, on top of whatever he can get from the families back home. You’re seeing the rehab and sober house managers getting arrested here and there and they are cracking down, but all of them are just tiny players in this overall fraud. Remember two things …THIS IS YOUR INSURANCE MONEY, and this is all able to happen because of a 40 year old, 30 day treatment plan that WAS NEVER DESIGNED TO TREAT HEROIN ADDICTION IN THE FIRST PLACE. No one has looked back this standard of treatment and its’ timeline. If this insurance nightmare were a snake, this standard and protocol would be its head.

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