Fraudulant insurance claims denied would I still have to report?

[BladeSlap]

Who said they were a hazard?
None, but now they do have permission to access them.

If they are not a hazard, it’s none of the faas damn business, and their unlawful access if that database should have had some FAA folks in jail, but alas ceasar can do no wrong. Trusting gov to keep gov in check is laughable

 

[Salty]

If they are not a hazard, it’s none of the faas damn business, and their unlawful access if that database should have had some FAA folks in jail, but alas ceasar can do no wrong. Trusting gov to keep gov in check is laughable

Why do you believe it was unlawful? Trust me, I do not like the situation, but that's not the same as it being unlawful.

 

[MauleSkinner]

If they are not a hazard, it’s none of the faas damn business, and their unlawful access if that database should have had some FAA folks in jail, but alas ceasar can do no wrong. Trusting gov to keep gov in check is laughable

True, the penalties for government workers breaking the law are significantly different than the penalties for the rest of us breaking the law. That should be changed as well. But the fact remains that this was about fraudulent statements by numerous pilots.

 

[Salty]

So you have no problem with fraud?

I have a problem with the Faa taking action on medicals for what was actually financial fraud getting benefits not deserved.

 

[MauleSkinner]

I have a problem with the Faa taking action on medicals for what was actually financial fraud getting benefits not deserved.

I rephrased quickly, but not quickly enough.

I don’t have enough of a dog in the fight to say the methods are/were right or wrong, but I will agree they were illegal at that time.

@BladeSlap ’s statement was that this was “some FAA feel good action”. I don’t believe investigating fraud is a “feel good action”.

 

[TRC1969]

After the painful process of submitting 1300 pages to the FAA, and now in a holding pattern waiting for whatever they may think of next. My advice to the OP is to report everything, especially if he knows it can be successfully proven to be incorrect. I hated starting the process of being completely honest, however when the process is done I will not have to worry about the what ifs. I would hate to get in a scrape and have my cert pulled and then have to prove my innocence. It just makes better sense to do it on the front end. Currently the OP only has to prove the Dr is a liar, scammer, whatever…if things were to go bad one day then the focus is no longer on the Dr but the pilot/ex pilot.

 

[Salty]

After the painful process of submitting 1300 pages to the FAA, and now in a holding pattern waiting for whatever they may think of next. My advice to the OP is to report everything, especially if he knows it can be successfully proven to be incorrect. I hated starting the process of being completely honest, however when the process is done I will not have to worry about the what ifs. I would hate to get in a scrape and have my cert pulled and then have to prove my innocence. It just makes better sense to do it on the front end. Currently the OP only has to prove the Dr is a liar, scammer, whatever…if things were to go bad one day then the focus is no longer on the Dr but the pilot/ex pilot.

What makes you think you won’t have to prove it again later?

 

[kell490]

After the painful process of submitting 1300 pages to the FAA, and now in a holding pattern waiting for whatever they may think of next. My advice to the OP is to report everything, especially if he knows it can be successfully proven to be incorrect. I hated starting the process of being completely honest, however when the process is done I will not have to worry about the what ifs. I would hate to get in a scrape and have my cert pulled and then have to prove my innocence. It just makes better sense to do it on the front end. Currently the OP only has to prove the Dr is a liar, scammer, whatever…if things were to go bad one day then the focus is no longer on the Dr but the pilot/ex pilot.

I agree should be as honest as you can but how does one remember every single time they saw a doctor, or went to the ER in their entire life by the time you get into your 60's don't remember everything you ever did when you were 12 years old. If you flood them with 1300 pages will they even look at it all just shove it into a corner, and forget about it because they can they know nothing anyone can do about it. Obviously a conditions that you currently have has to be discussed with them I can understand how 1300 pages could be generated quickly in just a few years.

 

[TRC1969]

The only issue the FAA even cares about has a specific start date and my records were all pretty easy to find, organize, and submit. But you are correct even with my records I am sure there is something I left out. It’s impossible to remember everything but if it’s missing they will never be able to say it was intentional considering everything I sent. I used to tell the people that worked for me when it came to federal regulations to be as right as they could be as often as they could be. I have read too many horror stories about knock down drag outs with the FAA that seem to take forever to get resolved. Maybe they will get tired of looking through my file and give me a pass.

 

[Palmpilot]

If they are not a hazard, it’s none of the faas damn business, and their unlawful access if that database should have had some FAA folks in jail, but alas ceasar can do no wrong. Trusting gov to keep gov in check is laughable

Why do you believe it was unlawful? Trust me, I do not like the situation, but that's not the same as it being unlawful.

It's in the article linked in post #30. Briefly, the courts found that the government violated the Privacy Act. The Supreme Court overturned the awarding of damages for mental or emotional distress, but not the finding of a violation.

 

[TRC1969]

What makes you think you won’t have to prove it again later?

I guess my thinking is if they have everything on the first go round there won’t be anything to discover if things were to go sideways. But maybe I’m wrong because I do know the goal is to prove it was not any fault of the FAA!

 

[BladeSlap]

It's in the article linked in post #30. Briefly, the courts found that the government violated the Privacy Act. The Supreme Court overturned the awarding of damages for mental or emotional distress, but not the finding of a violation.

Gov rules in the favor of gov, you did wrong but we won’t even slap a wrist, this is how we end up in the problems we have

 

[Matthew Johnson]

So if an MD’s office mistakenly billed my insurance for a hysterectomy I (male) have to disclose that on an FAA medical form? Knowing the FAA they would ask for more information.

Excuse to send the FAA a photo of your nether region?!?!

 

[mryan75]

I've had fraudulent claims put on my records from a psychiatrist and successfully got every single claim rejected

Um, not for nothing, but what were you seeing a psychiatrist for? This story seems “lacking” to me…

 

[Jeff Oslick]

Um, not for nothing, but what we’re you seeing a psychiatrist for? This story seems “lacking” to me…

If you read the thread, OP never saw this doc. It was fraud.

 

[Vas]

Well, this sure is a thread. Call AOPA's medical/legal advice line. There is a right answer to this, it's a simple answer for a simple reason, and there is no "agree to disagree" over the right answer. I am a lawyer, but I am not your lawyer, so I'm not gonna tell you what that answer is. Go get some real legal advice for free or nearly free from AOPA.

 

[mryan75]

If you read the thread, OP never saw this doc. It was fraud.

I find it very odd that a psychiatrist would just randomly charge things to the insurance of someone he had never seen as a patient. How did the doc get his personal details, never mind his insurance information? Finding someone’s name and address to scam them is one thing, finding their insurance provider, group and/or individual insurance information? I’m a bit skeptical of that.

 

[Jeff Oslick]

I find it very odd that a psychiatrist would just randomly charge things to the insurance of someone he had never seen as a patient. How did the doc get his personal details, never mind his insurance information? Finding someone’s name and address to scam them is one thing, finding their insurance provider, group and/or individual insurance information? I’m a bit skeptical of that.

It probably happens more often than you think. All of this information is on common systems within large medical groups.

 

[Palmpilot]

It probably happens more often than you think. All of this information is on common systems within large medical groups.

And it seems to be SOP that they use the patient's birth date to verify identity, which I'm guessing is not difficult information to find.

 

[MIFlyer]

Yeah totally they have documents that literally say it was an error, mistake, and there were never any real services provided by the practitioner

YOU need to get copies of those things and keep them. The insurance company might lose them at some point. I'd get them and keep them (scanned backed up online as well as copies in your safe.

 

[kell490]

I called trying to get my insurance codes from an insurer I had 10 years ago they said I had to write them. I received a letter back stating the Employee Retirement Income Security Act (ERISA) and the Heath Insurance Portability and Accountably act of 1996 (HIPAA) says they only have to retain information for 6 years. They are not obligated to provide anything after 6 years not sure how anyone is getting records from Insurance companies after 6 years if the insurance company themselves can't pull it up.

 

[MauleSkinner]

I called trying to get my insurance codes from an insurer I had 10 years ago they said I had to write them. I received a letter back stating the Employee Retirement Income Security Act (ERISA) and the Heath Insurance Portability and Accountably act of 1996 (HIPAA) says they only have to retain information for 6 years. They are not obligated to provide anything after 6 years not sure how anyone is getting records from Insurance companies after 6 years if the insurance company themselves can't pull it up.

They didn’t say they can’t…they said they’re not obligated to.

 

[kell490]

They didn’t say they can’t…they said they’re not obligated to.

That is what the letter said when I spoke to them on the phone they could not find anything said to write see if it had been archived not sure what that means. I think it meant they are not obligated to spend the resources to even look further then they did on the phone in the computer system. I can't see how the FAA can pull it up on their computer if the insurance company is not able to.