3 Most Common Types of Healthcare Fraud with Angel Cellucci | Ep. 287

• Angel explains that abuse occurs when providers charge more than they should for services received (e.g., $20 for tissues), while fraud involves knowingly billing for services not provided or at higher rates than warranted.

Hospitals are notorious for raising their prices between 400 and 500%. Like who else does that in any other industry?

• Angel outlines the three most common types of billing fraud that consumers encounter:

• Angel's mother billed $500 for an office visit in Pennsylvania while she was in Florida

• Client billed for six IVs during a same-day procedure when only one was used

• Angel's daughter billed for anesthesiologist rates when her oral surgeon administered anesthesia

• After reviewing 28 years of data from her fraud investigation company, Angel discovered that 93% of medical bills contained errors or fraud, yet insurance savings never reached consumers.

We've saved the insurance carriers millions, millions of dollars. Yet our premiums, our out-of-pocket expenses, and our deductibles are still going higher and higher.

• Angel created the DOVE framework to make her professional system accessible to everyday consumers, including her 93-year-old aunt.

• Angel recommends using a medical appointment journal to record provider seen, time spent, diagnosis, treatment, follow-up care, copay paid, and CPT/ICD-10 codes used.

If you go see your providers in January, and then you don't start getting bills until August or September... are you really going to remember every single detail that occurred nine months ago?

• Angel references Marie Kondo's principles, recommending a dedicated binder, accordion folder, or filing cabinet for all medical-related information including notes, bills, insurance info, and medications.

• Wait for your Explanation of Benefits (EOB) before verifying. Compare bills against documentation looking for double-billing, charges for services not received, or upcoding.

I look at every single medical bill as guilty until I prove it as being innocent and accurate.

• When errors are found, communicate in writing with return receipt requested for a paper trail. Providers must respond within 30 days by law. Always request interest-free payment plans instead of using credit cards.

This system was designed to serve us, not bankrupt us. We have more power than we realize.