Talk of The Villages Florida

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-   The Villages, Florida, General Discussion (https://www.talkofthevillages.com/forums/villages-florida-general-discussion-73/)
-   -   Villages Health DOJ investigation (https://www.talkofthevillages.com/forums/villages-florida-general-discussion-73/villages-health-doj-investigation-355501/)

Pat2015 01-01-2025 10:57 AM

Quote:

Originally Posted by golfing eagles (Post 2397926)
I'm sorry, but the posts that you have already made would suggest otherwise---so no, not happy

Well sounds like you’ve got all the answers about me and this matter based on the email you got, and your research. My 20 years as a Federal Agent resulting in multiple Medicare civil fraud settlements and criminal referrals certainly can’t compete with that.

Cheapbas 01-01-2025 11:02 AM

Quote:

Originally Posted by Caymus (Post 2397742)
Don't all Federal Agencies only correspond by US Mail?

Yes, they would have contacted you by letter, maybe in person. All the data they have were from massive attacks on institutions.

DONT EVER give account information to an incoming phone call. Decline, block, contact the agency they claim to be representing directly by using information on their official sites.

Pat2015 01-01-2025 11:08 AM

Quote:

Originally Posted by golfing eagles (Post 2397905)
She knows the same way that I do---we are EXPERTS in this field, unlike those who have spouted out a bunch of garbage on this thread.

I actually know quite a bit about Medicare fraud as I was a Federal Agent that investigated Medicare providers for “over billing.” That’s why I said that there might be an ongoing investigation and it will be interesting to see how it will be resolved.

Aces4 01-01-2025 11:18 AM

Quote:

Originally Posted by Pat2015 (Post 2397930)
Well sounds like you’ve got all the answers about me and this matter based on the email you got, and your research. My 20 years as a Federal Agent resulting in multiple Medicare civil fraud settlements and criminal referrals certainly can’t compete with that.

Some of the "critical thinkers" can't critically think past their own experiences. I am tangling with a coding mess on a bill right now and I have to wonder how much of these coding issues are errors or intentionally coded for higher payment.

In my case they admit to the error, still have the bill on my account and it's taking over 2 months to get the mistake corrected. It now has to go to a board to nullify the charge. What a joke! For clarification, this case does not involve the Villages Hospital.

Pat2015 01-01-2025 11:31 AM

Quote:

Originally Posted by Aces4 (Post 2397945)
Some of the "critical thinkers" can't critically think past their own experiences. I am tangling with a coding mess on a bill right now and I have to wonder how much of these coding issues are errors or intentionally coded for higher payment.

In my case they admit to the error, still have the bill on my account and it's taking over 2 months to get the mistake corrected. It now has to go to a board to nullify the charge. What a joke! For clarification, this case does not involve the Villages Hospital.

Been there with incorrect billings, and it shouldn’t take multiple attempts to get it corrected. Sorry for what you are going through!

jump4 01-01-2025 11:35 AM

The Villages Health won't even accept traditional Medicare Part B.
 
The Villages Health won't even accept traditional Medicare Part B. Something's got to be wrong with that! :mad:

Quote:

Originally Posted by golfing eagles (Post 2397790)
Rotten??? Really???? How so????

Every health care provider has the right to decide which insurances they will and will not accept. We reviewed this every year when the contracts came around. So did every other practice in the country. Sorry you "never heard of this". It is neither "rotten" nor cause for TVH to be "looked at closely", I always wonder where people get these ideas from.


Bogie Shooter 01-01-2025 11:41 AM

Quote:

Originally Posted by Pat2015 (Post 2397888)
The poster presumes a lot about the specifics of the overpayments, and is certain that there is no investigation. We’ll see how this ultimately works out.

Yes, we shall see.

OrangeBlossomBaby 01-01-2025 11:50 AM

Quote:

Originally Posted by jump4 (Post 2397953)
The Villages Health won't even accept traditional Medicare Part B. Something's got to be wrong with that! :mad:

The Villages Health is a participating provider for regular non-Medicare health insurances of a pretty broad variety, from FloridaBlue to Cigna. The only Medicare-type insurance they accept are some of the Advantage products.

There are private practices that don't accept any insurance at all, and some that will take FloridaBlue, but not UH Medicare, and won't accept any Advantage products at all. And then there are the HMOs, that accept ONLY patients enrolled in THEIR HMO, and no other insurance at all, of any kind.

This is what happens when health care is commercial and for-profit. They don't have to accept any insurance, and they can pick and choose which insurance they'll accept. If they're not "participating providers" then you either pay their prices, or you find a participating provider.

JanRoberts 01-01-2025 11:59 AM

My husband and I are getting texts and emails with a letter explaining what's happening. They aren't requesting any information.

tophcfa 01-01-2025 12:01 PM

Quote:

Originally Posted by golfing eagles (Post 2397790)
Rotten??? Really???? How so????

Every health care provider has the right to decide which insurances they will and will not accept. We reviewed this every year when the contracts came around. So did every other practice in the country. Sorry you "never heard of this". It is neither "rotten" nor cause for TVH to be "looked at closely", I always wonder where people get these ideas from.

Are you aware of other signature health care providers, serving a senior citizen community, that doesn’t accept traditional Medicare?

Bill14564 01-01-2025 12:01 PM

Quote:

Originally Posted by OrangeBlossomBaby (Post 2397962)
The Villages Health is a participating provider for regular non-Medicare health insurances of a pretty broad variety, from FloridaBlue to Cigna. The only Medicare-type insurance they accept are some of the Advantage products.

There are private practices that don't accept any insurance at all, and some that will take FloridaBlue, but not UH Medicare, and won't accept any Advantage products at all. And then there are the HMOs, that accept ONLY patients enrolled in THEIR HMO, and no other insurance at all, of any kind.

This is what happens when health care is commercial and for-profit. They don't have to accept any insurance, and they can pick and choose which insurance they'll accept. If they're not "participating providers" then you either pay their prices, or you find a participating provider.

A provider that will not take traditional medicare is a poor fit for a community populated primarily by medicare-aged patients.

golfing eagles 01-01-2025 12:19 PM

Quote:

Originally Posted by Pat2015 (Post 2397930)
Well sounds like you’ve got all the answers about me and this matter based on the email you got, and your research. My 20 years as a Federal Agent resulting in multiple Medicare civil fraud settlements and criminal referrals certainly can’t compete with that.

Based on e-mail and research???? NO, not at all. Based on 40 years of medical practice and hospital administration. So, just which "Federal Agency" did you work for?????

golfing eagles 01-01-2025 12:20 PM

Quote:

Originally Posted by Pat2015 (Post 2397935)
I actually know quite a bit about Medicare fraud as I was a Federal Agent that investigated Medicare providers for “over billing.” That’s why I said that there might be an ongoing investigation and it will be interesting to see how it will be resolved.

And yet your posts fail to show any expertise in this area whatsoever.

golfing eagles 01-01-2025 12:22 PM

Quote:

Originally Posted by jump4 (Post 2397953)
The Villages Health won't even accept traditional Medicare Part B. Something's got to be wrong with that! :mad:

No, there is ABSOLUTELY NOTHING WRONG WITH THAT. Dealer's choice.

golfing eagles 01-01-2025 12:24 PM

Quote:

Originally Posted by tophcfa (Post 2397972)
Are you aware of other signature health care providers, serving a senior citizen community, that doesn’t accept traditional Medicare?

To start with, every concierge practice, of which there are hundreds in Florida alone


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