May 15, 2010
By W. Michael Thomas, CFP, CLU, CH.F.C., R.F.P.

March was Fraud Prevention Month. It reminds us to be aware of identity theft, credit/debit card fraud and various other schemes perpetrated through emails, text messages and the Internet. Steps must be taken to protect ourselves from scams. Group benefit plans also face the challenges of fraud committed by both providers and consumers. Plan members can help prevent abuse and fraud.

As a plan member of a group benefits program, keep the following tips in mind when submitting a health or dental claim:
  • Never sign a blank claim form. Confirm the information on the form is correct when signing it. Your signature is the carrier’s assurance that you received the services for which you are being billed.
  • Never submit a claim before receiving the treatment, service or product.
  • Review the Explanation of Benefits that accompanies your claims summary.
  • Never give anyone your plan or policy numbers. Treat these as you would any confidential personal information.
  • Make sure you understand the treatments you receive. Ask questions if you don’t understand the process.
  • Keep records of your appointments, treatments and dates.
  • Complete claim audit questionnaires.

The end result of benefits plan fraud is higher premiums, or reduced benefits, or, in some cases, the complete loss of an affordable benefits program. By being aware of this threat to your benefits plan, and by following the above tips, you can play an active role in safeguarding the valuable coverage that helps to support good health and well-being for yourself and family members.

If you have any questions, please contact Michael Thomas at the address below.
W. Michael Thomas is a partner with The Investment Guild, endorsed provider of the HortProtect Group Insurance Program, and is a director of Ontario Horticultural Trades Foundation. 1-800-459-8990.