Ok…so I just let my frustration get the better of me and was a total idiot. The new federal regulation requires insurance companies to reimburse 8 COVID tests per person per month, so I’ve been buying 8 tests per month for myself, my wife and my child. Apparently my insurance company changed from per month to a rolling 30 day period, so the last claim was denied because it was a few days off and still within the 30 day period, but in a different month. I was so annoyed so I photoshopped a different date and order number into the receipt from the pharmacy and resubmitted it without reading through all the legal mumbo jumbo when pressing submit. Immediately afterwards, I was like, crap: is that insurance fraud? I immediately called the insurance company and gave them the reference numbers and told them to please cancel the claims as they were entered in error. I also immediately sent a secure message with the 3 reference numbers to cancel the claims. The total was for about $280. State is Connecticut. Here are the statutes involved. Would this be considered health care fraud? When it says $1000 fine or 1 year in prison or both, what does that mean? could it just be a fine?
Will having cancelled the claims before they are processed, right after submitting them, fix this? I’m flipping out over here. I’m not a criminal-just an idiot who let his frustration get the better of him. Please help!
submitted by /u/throwawayins123
[link] [comments]Ok…so I just let my frustration get the better of me and was a total idiot. The new federal regulation requires insurance companies to reimburse 8 COVID tests per person per month, so I’ve been buying 8 tests per month for myself, my wife and my child. Apparently my insurance company changed from per month to a rolling 30 day period, so the last claim was denied because it was a few days off and still within the 30 day period, but in a different month. I was so annoyed so I photoshopped a different date and order number into the receipt from the pharmacy and resubmitted it without reading through all the legal mumbo jumbo when pressing submit. Immediately afterwards, I was like, crap: is that insurance fraud? I immediately called the insurance company and gave them the reference numbers and told them to please cancel the claims as they were entered in error. I also immediately sent a secure message with the 3 reference numbers to cancel the claims. The total was for about $280. State is Connecticut. Here are the statutes involved. Would this be considered health care fraud? When it says $1000 fine or 1 year in prison or both, what does that mean? could it just be a fine? Will having cancelled the claims before they are processed, right after submitting them, fix this? I’m flipping out over here. I’m not a criminal-just an idiot who let his frustration get the better of him. Please help! submitted by /u/throwawayins123 [link] [comments]Read Morer/HealthInsurance