The Company is owned and operated by Kenny Marcus who claims to have once lum sum net $250,000 from Medicaid. Claims to have contacts in Medicaid and can apply for Medicaid with out the patient and recent lum sum nets $85,000. The Company collects the SS# and other information of HOME LESS patients from Hospitals, then files claims with out the patient. There has been talk of filing for undocumented / illegal aliens.
Talk of bringing in a former Medicaid male employee who knows the in and out of Medicaid. The idea is everyone has insurance, whether or not, there is Medicaid.insurance companies are never told this is a collection agency, a very BIG code there.in some cases after years of a claim there is an effort to gain some kind of proof of timely filing that does not exists or other issue.
Whatever fraud a collector can use against an insurance company. A representative will go to the hospital and attempt to find one through out the medical records. Some of the time they attack some patient with credit report checking, collection notices, and phone calls. The patient then may attempt to reopen the claim. They then claim to be the Hospital and argue proof of timely filing or other issues. Another scam is to blame patients for their proof of timely filing insurance troubles and demand immediate cash. At this point they may get the patient to have a 3-way conversation with the insurance company. Depending on whom is dumber, the insurance agent or patient, arrangements of payment may be made.
The insurance company will NEVER hear Professional Claims Bureau. The employees are brain washed by Kenny Marcus to the belief they work for some place other than a debt collector. They tell them what's going on at the Hospitals billing dept. Names of people who are the bosses there etc
A patient who goes to more than one Hospital can be tracked through their system, which has more medical records on a patient than one Hospital. They then will get an SS# from one file, attach it to another and bill Medicaid. It doesn't matter who the patient really is or not, as long as Medicaid "their sucker" will pay it. They spend hours finding how many Hospital visits patients attended with in a 2-year period. There are cases of people with no SS# who may have similar ID's to Medicaid holders who now have Medicaid.
You can find the phone numbers of just about every insurance company on their computer Rolodex. There is some talk about mail fraud there as well because patients who have insurance have complained about letters for payment 2-3 years later. Most of the people they go after have insurance. And as far as they are concerned those who don't, must have Medicare and Medicaid. It doesn't matter what the Hospital did concerning the claim, as long as there is an insurance company to bill. This company could not tell you a billing code from a hole in the wall. They print up their own Hospital letter heads etc. The only advantage is the elements of fraud. They're also fond of the New Jersey system as well but not Connecticut.
Stopcrime
new york, New York
U.S.A.
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