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Saul Acosta
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Here is the BEST most LOGICAL and SIMPLEST answer to the PIP issue in Florida. Please read on and do not discard. Afterwards, I will leave my email for anyone to contact me if you are genuinely serious and wishes to have an educated non confrontational argument over the matter. First and foremost, my opinion is for the benefit of the consumer,not for the FILTHY and CORRUPT POLITICIANS nor for the Folks out there that are involved in the health care industry and engage in defrauding the Insurance companies. This solution/recommendation as of today 01-30-2012 has been COMPLETELY IGNORED by all politicians we have contacted and surprisingly "NOBODY" from any of the "ANTI PIP" rallies or group meetings i have attended have not even mention anything about it. Here is the first step in arriving at the solution. Has anyone consider the possibility as remotely and absurd as it may seem that maybe the INSURANCE COMPANIES are lying and inflating these dollar figures resulting from PIP fraud so they can continue hiking their rates? Lets see lets do a simple math,.. Most Fraudulent clinics that are engage in staging accident do the following; 1. Buy an auto policy for the person who is to become their patient in 6 months.Lets says the policy costs the scum clinic owner $300 per month. A figure that is really,really low and the person with the new obtained policy must wait at least 6 months before staging the accident. So $300X6=$1800.This is money for the insurance pocket. Now after 6 months the accident is "staged" and the policy holder makes a claim. The Deductible on the policy $1000(minimum). The driver goes to a clinic and receives what amounts to $10K in the medical treatments. How much of the actual $10K does the insurance pay? lets do math again. $10K minus 80% and minus the Deductible will roughly equal to about $8K in monies that the clinic is expecting to get paid from the insurance. Is this the amount they pay? NOOOOOO.Most insurance offer a payment proposal of typically half the amount. So the $8K is now approx $5K after deducting the $1800 and $1000 from the previous payments the $5k-$2800=$2200. This figure of $2200 per "FRAUDULENT CLAIM" is likely the most realistic figure that I can come up with. Now lets multiply this by the number of fraudulent claims each year and i am sure that the figure would be allot less than the BILLION DOLLAR FIGURE claimed by the Insurance companies and Politicians. What I suggest as a Citizen and concerned consumer is that an independent party not affiliated with anyone other than the consumer perform a FORENSIC DETAIL ACCOUNTING of the figures claimed by the insurance companies as fraud claims. If the results are factual then we move to the SOLUTION and if the results are exaggerated by the insurance companies then we ought to CHARGE them CRIMINALLY for lying to the consumer and hence committing insurance fraud. The Solution. Get every AHCA clinic in the State of Florida to have a THUMB PRINT SCANNER SOFTWARE at the facility. The patient most render a THUMB PRINT at the beginning of therapy and at the END OF THERAPY along with a digital photo. The same most be done by the THERAPIST who administers the therapies.He/She most render a thumb print at the beginning and END of each patient worked upon. The scanner and thumb print software must be paid by the clinic wishing to bill for such services. NOT BY THE STATE. This will not 100% put an end to PIP FRAUD but when a person willing to engage in staging accidents realizes that He/She needs to visit a particular Health Care Clinic a minimum of 28-30 times to justify billing for the maximum policy amount this would make it very unpleasant and for the "Fraudulent patient to account for the typical $2000 clinics pay their patients. Again this will not put a stop to the Insurance Fraud but it would make it less likely for folks to participate in such a crime. Conservatively this will diminish Insurance Fraud at least 50%. Next step is to make all those facilities in Florida categorized as EXEMPT CLINICS to either shut down or to get an AHCA certificate to operate. This is a solution that we presented in writing and verbally to all the involved agencies and to numerous politicians yet no one has even call us or written back to us. This is the simplest,least expensive and most convenient way to resolve this problem. We are a Medical Staffing company based in Miami we cater to hundreds of medical facilities in the state of Florida and we would love nothing more that to see a genuine solution to this problem. We have an attorney full time on staff every day ensuring that our Doctors and our clients are doing things ethically,morally and with full honesty. The problem with this issue is more political than in the interest of the consumer. I challenge anyone to have a genuine email dialog with me to find a more effective solution. Lastly, Please ensure that NO POLITICIAN profits from any legislation proposed in this matter.Email comments to kaizenmedical@gmail.com
Toggle Commented Jan 30, 2012 on PIP insurance fraud explained at Naked Politics
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Jan 30, 2012