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Alternative Treatments in MexicoMexico (especially Tijuana, Mexico) has become a common destination for patients who have been diagnosed with untreatable or terminal illnesses (cancer, heart disease, Multiple Sclerosis, chronic fatigue, arthritis, etc) because a number of unscrupulous providers promote cures through unconventional, unproven, and often disproved (or dangerous) methods of treatment. These providers prey on patients who are looking for that special miracle that might prolong or even save their lives.While these alternative therapies are usually claimed to be useful in the treatment of any number of degenerative diseases, the providers are usually unable to show the effectiveness of the treatment under properly controlled clinical trials. Some patients are treated with radical alternative methods that may even put their current state of health at risk, while others are treated with therapies that are not even sufficient to treat the level of disease that has been diagnosed. As a patient, you should be aware that you may put your current state of health at risk when using these alternative providers, in addition to putting your financial situation at risk. Claims for these alternative services often run into tens of thousands of dollars. Blue Cross Blue Shield of Montana carefully monitors and reviews these claims for several reasons.
Second, many of these claims include fraudulent or misleading information meant to deceive the insurer and cause them to pay for services that otherwise wouldn't be paid. Should you choose to receive services from one of these providers, you would be asked to answer a number of questions related to your claims - as well as authorizing the release of records so Blue Cross Blue Shield of Montana can investigate the information submitted on your claims. Your claims will not be processed until a complete investigation has been completed. If you have questions about a Mexican provider or the services they provide, please contact our Special Investigations Unit before you receive the services. Corporate NHCAA MembershipBlue Cross Blue Shield of Montana is a corporate member of the National Health Care Anti-Fraud Association (NHCAA). The NHCAA and its membership are committed to improving the prevention, detection, investigation, and civil and criminal prosecution of health care fraud by:
NHCAA membership is comprised of numerous private and public-sector organizations and individuals including the US Department of Justice, the Federal Bureau of Investigation, the US Department of Health & Human Services, the National Association of Attorneys General, the Blue Cross Blue Shield National Association and dozens of other insurers - including over 25 individual Blue Cross Blue Shield Plans. Protect your BCBSMT ID CardYour BCBSMT ID Card and policy number should only be used by yourself or an authorized dependent on the coverage. As a consumer, you should protect this information as you would a credit card number. Do not provide this information to anyone except your provider and do not lend your card to someone else for any reason.Recent scams have targeted unprotected ID numbers, resulting in fraudulent claims submitted to the patient's insurance company without the patient's knowledge. If you ever receive an Explanation of Benefits for services you did not receive, please contact our Special Investigations Unit immediately. Nothing is "Free"Many providers offer free or discounted services as a means of attracting new business. Sometimes providers will not pass these discounts along to your insurance when claims are filed. The result is an increase in payments that could affect your coverage or rates in the future.If you receive an Explanation of Benefits for services that were supposed to be free or do not reflect a discount you received, please contact our Special Investigations Unit immediately. Health ApplicationsWhen completing an application for coverage with Blue Cross Blue Shield of Montana, be careful to include a complete medical history detailing conditions that have been treated, prescriptions you have taken, and any treatment that has been recommended or you expect to receive in the future.Misrepresented or omitted information on an application can result in cancellation of your coverage. Intentional misrepresentations or omissions can also lead to criminal charges. If you have questions when completing your application, be sure to ask your agent or contact Blue Cross Blue Shield of Montana directly. |
Take Responsibility!!!As for Consumer Awareness, the most important thing we can probably tell you is to take personal responsibility for your health care and the expenses related to this care.Become an informed consumer of your health care and make sure you know as much as possible about the providers you use and the treatments they provide. The story on this page about Alternative Treatments in Mexico is especially troubling to us because of the number of unscrupulous providers in this location that prey on people who are at a critical point in their treatment. Unfortunately, unscrupulous providers can take away a patient's chances of recovery by promoting expensive treatments that aren't proven to work. Curable cancers are often treated with alternative treatments - only to have the patient die after incurring tens of thousands of dollars in treatment. In the interest of your family's financial condition, please be careful in choosing your health care. |