Wednesday May 25, 2022

You can detect scams yourself. Apply for a medical record

Check your medicine, call a health insurance company. Some doctors associate the costs with services that they did not actually perform at all. The inscription from this policyholder can be obtained free of charge and it is possible that in the end it is surprising how much health care I received in the past year.

ten Petra, a client of the Oborov health insurance company of employees of banks, insurance and construction (PWD), was interested in what kind of health was shown by her health insurance company, so she applied for an entry from her policyholder.

The result surprised her. She found out that a dentist from a medical facility in Prague 7, where she was treated only once in 2005, regularly receives thousands of crowns in costs each year. “According to my inscription, she insisted a few teeth for me during the years 2007-2009, so she asked for a total of 3,456 crowns for the insurance company,” Petra wrote to the iDNES.cz editorial office.

The situation was exactly the same for her husband. So he visited the cogwheel only once. From the entry he had issued, he found out that in the years 2007-2009 he drank a few thousandths, in particular by 3,294 crowns.

Improperly reported dental procedures only shaded

Petra and Manel were outraged by the teeth. On the days when, according to the inscription, she was supposed to seal their teeth, they were even abroad, where they both work for a long time. “Of course, I turned to the insurance company with the understanding that the actions performed are unjustified,” Petra describes her reaction.

The insurance company immediately began to investigate the case and immediately turned to the conclusion that the doctor actually reported the costs of both men unjustifiably and deducted the entire amount. This case for the disabled is over.

Bohuel did not satisfy Petru with the way in which his case was closed, and she wrote to the editorial office: “Vnmm, at least in particular, stated that the insurance company only paid off these first paid pensions. If you find that it is not a mistake, but a systematic rule, it should, in my opinion, react much harder. When a thief attempts to steal something from a store and is caught, he is not only punished by the fact that he has to shake the stolen thing. ”

We asked the OZP representative about the reaction. “The medical facility is always assessed in the whole, especially with regard to the audit activity of the report. One of the decisive criteria is the ethnicity and the number, possibly repeated, of the identified shortcomings. This was the first case of a change in medical care. Therefore, it was only carried out and this device was included among the devices with the so-called revision activity, ”Mario Bhme summed up the procedure of the insurance company.

We follow the problems of the lkae, the hardness of the insurance company

OZP admitted in the week about the case of thin Petra, she admitted that she would exchange things at the medical facility, where she was clearly in doubt. This procedure was followed by health insurance companies. “If we find out that there has been an unjustified relocation of medical care, then we will draw the attention of the medical facility to this fact and, according to it, we pay special attention to it,” explains Zuzana Brvnkov from Zdravotní pojiovny Metal-Alliance.

He gave the procedure depending on whether the drug will be the first and only one of the doubts or repeated unjustified reporting of health care. If a mistake is made, the bonding agent will always take the pension off unintentionally. “If the code is in case and if a criminal offense is suspected, we will have the case in cooperation with the Police R, in the extreme case we will terminate the contractual relationship,” adds Elenka Mazurov, a spokeswoman for the ZP industry.

Pretending the mind is sloit

Any mistake in the reporting provided is a fraudulent one. “If the mind is not particularly important, it is not possible to unjustifiably consider health care to be an unlawful act and the case to be handed over to one of the authorities in criminal matters,” Mazurov warns.

From the practical point of view, health insurance companies are aware of cases where errors occur in the back of the birth line, changes in the name of the insurer or the amount of the file, which is reported by the performance and medical material. “Mistakes in native hearing occur in siblings and in the same name when the medical facility uses the name of the namesake to print out,” explains Petr Kvapil from ZP koda.

Get a free medical report

In order to find out if your health insurance company has performed the services they actually performed, you need to apply for an entry from that insurance company, as Petra did. “Patients have the right to submit their health insurance company once a year for a free written entry from the personal here about the reporting of health care,” explains Hana Kadekov, a spokesman for the Health Insurance Company of the Ministry of the Interior.

By entering, you will receive health information paid by the insurance company in the period of the last 12 months, including paid regulatory fees and surcharges, and a wall of paid payers and foodstuffs for special medicine. “The processing of the necessary data requires a certain amount of time, and therefore it is advisable to provide an overview of health care data for 2009 at the earliest in April this year,” reminds Ji Rod, speaks VZP.

At your level, health insurance companies will process entries even for a period of less than one year. For example, the Revrn fraternal treasury will provide an entry for the current and the previous calendar year, as well as the Czech Ministry of Interior and the Ministry of the Interior of the Ministry of the Interior for three years.

In the ZP code, you can also enter for special individual entries, for example, it concerns only some areas of health care, such as medicines, dental care, etc.

Get the entry at the branch or view it on the Internet

Health insurance companies can get information about their insurance in many ways. You have the opportunity to go in person to the branch, where you will have an entry for the deposit of the insurance company’s prepayment order.

You can apply for it in writing and you will also receive it in writing in a registered letter. It is possible to enter them electronically via the website of the website.

Some health insurance companies can go longer and their users can look at their information about reporting via the Internet at any time. Pat among n ZP Ministry of the Interior, esk prmyslov ZP, ZP Metal-Alliance, ZP Mdia and VZP.

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