[Kahuna32162]

Just received a call from from 2 people who identified themselves as investigators for the Department of Justice, looking into Medicare billing practices at the village’s health. I first thought it was a scam, but after hearing the personal information they had on our records, I was inclined to cooperate with their inquires.

They mostly wanted to confirm conditions listed in our files and confirm they were correct. Most conditions were not correct, especially type 2 diabetes.

I’ve thought for years that the Village’s Health was a scam. This active investigation might just be the tip of the iceberg.

[Mrprez]

???

[OrangeBlossomBaby]

Pretty sure you just got scammed by people taking advantage of billing errors and pretending to be members of the Dept. of Justice.

[vintageogauge]

Originally Posted by OrangeBlossomBaby

Pretty sure you just got scammed by people taking advantage of billing errors and pretending to be members of the Dept. of Justice.

And exactly how did they get scammed and what did they get scammed out of? They didn't say they gave them information, they already had their medical records so they would have had to scam someone else that had the records.

[CarlR33]

Originally Posted by OrangeBlossomBaby

Pretty sure you just got scammed by people taking advantage of billing errors and pretending to be members of the Dept. of Justice.

I would agree…..from a simple web search below. While they only corrected information it maybe a test and the next call will be more in depth since they know you can be trusted over the phone. Also, you had to correct information they claimed they had so more than likely a phishing exercise setting you up for the next call that could be more a scam.

“If you receive a phone call claiming to be from the Department of Justice, be very cautious as it is likely a scam; legitimate government agencies, including the Department of Justice, will rarely contact you by phone to ask for personal information or money.”

[Bill14564]

Originally Posted by CarlR33

I would agree…..from a simple web search:

“If you receive a phone call claiming to be from the Department of Justice, be very cautious as it is likely a scam; legitimate government agencies, including the Department of Justice, will rarely contact you by phone to ask for personal information or money.”

And if they only listened to personal information rather than providing it?


I agree that it sounds shady and I’m not sure how much I would say of if I was called.

[melpetezrinski]

Originally Posted by Kahuna32162

Just received a call from from 2 people who identified themselves as investigators for the Department of Justice, looking into Medicare billing practices at the village’s health. I first thought it was a scam, but after hearing the personal information they had on our records, I was inclined to cooperate with their inquires.

They mostly wanted to confirm conditions listed in our files and confirm they were correct. Most conditions were not correct, especially type 2 diabetes.

I’ve thought for years that the Village’s Health was a scam. This active investigation might just be the tip of the iceberg.

Here is an excerpt from what I just received from The Villages Health (“TVH”) "we discovered a problem with some of our Medicare billing practices. Upon discovering a potential problem with our Medicare billing this past Fall, TVH hired outside consultants to conduct an in-depth review of our coding and billing practices. Based on our investigation, we determined that
beginning in 2020, TVH implemented certain billing processes and practices that were not consistent with Medicare payment policies. This resulted in TVH receiving more money from the Medicare program than if billed correctly.
With these consultants, we are now working to identify the financial impact of these billing errors and are in the process of repaying the Medicare program for any overpayments that resulted from the billing issue. In addition to
starting work with relevant government agencies to return the overbilled Medicare funds, we have also already begun to implement a range of new internal safeguards to assure that an error such as this will not recur. The occurrence of these errors has since been self-reported to the proper U.S. government agencies, and we expect a smooth process as we work diligently to make right with the Medicare program itself—all with the goal of continuing to provide you with the best possible care you’ve rightfully come to expect from all of us at TVH."

[Bogie Shooter]

Originally Posted by melpetezrinski

Here is an excerpt from what I just received from The Villages Health (“TVH”) "we discovered a problem with some of our Medicare billing practices. Upon discovering a potential problem with our Medicare billing this past Fall, TVH hired outside consultants to conduct an in-depth review of our coding and billing practices. Based on our investigation, we determined that
beginning in 2020, TVH implemented certain billing processes and practices that were not consistent with Medicare payment policies. This resulted in TVH receiving more money from the Medicare program than if billed correctly.
With these consultants, we are now working to identify the financial impact of these billing errors and are in the process of repaying the Medicare program for any overpayments that resulted from the billing issue. In addition to
starting work with relevant government agencies to return the overbilled Medicare funds, we have also already begun to implement a range of new internal safeguards to assure that an error such as this will not recur. The occurrence of these errors has since been self-reported to the proper U.S. government agencies, and we expect a smooth process as we work diligently to make right with the Medicare program itself—all with the goal of continuing to provide you with the best possible care you’ve rightfully come to expect from all of us at TVH."

I received the same text message. Appears they are doing the right thing.

[golfing eagles]

Originally Posted by melpetezrinski

Here is an excerpt from what I just received from The Villages Health (“TVH”) "we discovered a problem with some of our Medicare billing practices. Upon discovering a potential problem with our Medicare billing this past Fall, TVH hired outside consultants to conduct an in-depth review of our coding and billing practices. Based on our investigation, we determined that
beginning in 2020, TVH implemented certain billing processes and practices that were not consistent with Medicare payment policies. This resulted in TVH receiving more money from the Medicare program than if billed correctly.
With these consultants, we are now working to identify the financial impact of these billing errors and are in the process of repaying the Medicare program for any overpayments that resulted from the billing issue. In addition to
starting work with relevant government agencies to return the overbilled Medicare funds, we have also already begun to implement a range of new internal safeguards to assure that an error such as this will not recur. The occurrence of these errors has since been self-reported to the proper U.S. government agencies, and we expect a smooth process as we work diligently to make right with the Medicare program itself—all with the goal of continuing to provide you with the best possible care you’ve rightfully come to expect from all of us at TVH."

And now let's add the rest of the statement-----This event did not impact any patient care OR ANY PATIENT BILLING This is not uncommon with EMRs, they found a problem, notified CMS and will pay any overpayments back. I doubt the DOJ is even involved, and I'm 99.9999% sure the OP was scammed/phished.

[OrangeBlossomBaby]

Originally Posted by golfing eagles

And now let's add the rest of the statement-----This event did not impact any patient care OR ANY PATIENT BILLING This is not uncommon with EMRs, they found a problem, notified CMS and will pay any overpayments back. I doubt the DOJ is even involved, and I'm 99.9999% sure the OP was scammed/phished.

That's why I was pretty sure they were scammed. I got the same notification, and then went to the Villages Health's actual website and logged in to my account and checked my messages and saw that there, confirming that the e-mail notification and text message I received from TVH were legit.

And since they're legit, it means - the DOJ wouldn't be asking ME anything about MY health, to confirm or dispute anything TVH is or is not doing with their Medicare billing. Of course, anyone from the DOJ checking with me about MY Medicare billing info would be obviously lying since I'm not on Medicare in the first place.

But anyway - the DOJ won't call people on the phone to ask them about their health. It's clearly a scam. Just like when you get a call from the IRS saying you'll be going to jail unless you cough up your overdue fines. It's a scam.

[tophcfa]

Sounds like someone is trying to scam the OP. That being said, I wouldn’t be surprised if The Villages Health is being looked at closely. I’ve never heard of another health care operation that serves a senior population and won’t accept Medigap plans. Something about that smells very rotten.

[charlie1]

Definitely a scam! The DOJ would not discuss the issue about anyone's individual case without asking question first to identify the person 100% the person they want to talk with. Just because you answer the phone does not mean you are the person. These initial questions could be enough to get valuable information that they could use. Heck, even in the doctors/dentist/etc office they always ask for some information when you are there in person! I would suggest anyone getting a call ask for a VERIFIABLE DOJ telephone number or website that you can use to gather information on your own about thier investigation before answering any questions!

[Bogie Shooter]

Originally Posted by tophcfa

Sounds like someone is trying to scam the OP. That being said, I wouldn’t be surprised if The Villages Health is being looked at closely. I’ve never heard of another health care operation that serves a senior population and won’t accept Medigap plans. Something about that smells very rotten.

Why won’t they accept Medigap plans?

[Caymus]

Don't all Federal Agencies only correspond by US Mail?

[RoadToad]

Originally Posted by vintageogauge

And exactly how did they get scammed and what did they get scammed out of? They didn't say they gave them information, they already had their medical records so they would have had to scam someone else that had the records.

".. Most conditions were not correct .."

They collected this....