May 17, 2020

What Hospitals Can Do to Prevent Health Insurance Fraud

Health Insurance
Health Insurance
Admin
3 min
Fake pharmacies have also been reported to pose as legitimate companies.
Health insurance scams are on the rise, and the government and health care organizations are renewing their focus on stopping them.

While most health i...

Health insurance scams are on the rise, and the government and health care organizations are renewing their focus on stopping them.

While most health insurance providers are honest, there are some that sell fake policies and medical discount cards to their customers.

Advances in technology, better availability of information and greater awareness have helped the government, medical facilities, physicians and consumers combat fraud more effectively these days, but there is still a lot more to be done.

Here is a look at some common health insurance scams and measures that hospitals and other medical outlets can take to prevent them.

Fake Health Insurance Policies

Health insurance scammers often target individuals, small businesses and associations, and they try to trick them into buying their fake policies by promising low premiums and guaranteed approval without medical exams.

Many of them operate through sophisticated syndicates that have strong marketing and money-laundering capabilities, and they may even be linked to organized crime.

Usually, people who have purchased fake health insurance do not know that their policies are fake until they need to file claims.

Fake Obamacare Policies

While the implementation of Obamacare promises better health coverage for Americans, it also opened a new way for scammers to prey on health insurance buyers.

According to an article entitled "Health Insurance Scams Using Health Care Bill," health insurance scam artists began targeting seniors, low-income people and others who need health insurance desperately as soon as the new health care bill was passed.

While some of them offer fake Obamacare policies, others try to commit identity theft by telling their targets that they need their social security and bank account numbers to help them get a national health card.

Phony Medical Discount Cards

Phony medical discount cards are usually presented as a way to get discounts for various medical services or an alternative to health insurance.

These cards are often sold to low-income individuals and families. They come with lists of phony health care providers, fake discounts and high hidden fees, but they do not provide actual benefits.

Some of the sellers of phony medical discount cards also try to get people to disclose their personal information in an attempt to steal their identities.

Reducing Health Insurance Scams

There are a number of things that hospitals can do to prevent health insurance scams.

First of all, they can try to raise awareness of these scams and provide advice on how to avoid them. This can be done by sharing information about health insurance scams on their websites or newsletters, or during consultations.

Additionally, hospitals can use fraud detection software to combat health insurance fraud. 

The Fraud and Abuse Management System developed by IBM is an example of software that can help them reduce financial losses that result from health insurance scams.

It detects fraud by analyzing claims data and identifying insurance providers that deviate from the norms of their peer groups. Some hospitals have set up special investigation units to prevent health insurance fraud.

Health insurance fraud can have serious consequences for patients, medical organizations, insurance providers and the government.

It is a costly crime that should not be overlooked.

About the author: John McMalcolm is a freelance writer who writes on a wide range of subjects, from social media marketing to cloud computing.

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Jun 22, 2021

Bachem turns 50 - a timeline

pharma
supplychain
peptides
medication
3 min
As Bachem turns 50, we take a look at the company's history

Bachem, a supplier to pharmaceutical and biotechnology companies worldwide, is celebrating its 50th anniversary this month. We take a look at the Swiss company's history.  

1971 - beginnings

Bachem is founded by entrepreneur Peter Grogg in Liestal, a small town near Basel in Switzerland. Grogg started the firm with just two employees, and with a focus on peptide synthesis - peptides are composed of amino acids that have a variety of functions treating health conditions such as cancer and diabetes. 

1977 - 1981 - early growth

Bachem moves its headquarters to the Swiss town of Bubendorf, with eight employees. In 1978 the company produces peptides for use in medicines for the first time. In 1981 production capacity triples and the workforce grows to 150. 

 1987 - 1996 - worldwide expansion

The company expands into the US with Bachem Bioscience, Inc. in Philadelphia. To strengthen its presence in Europe, Bachem opens sales and marketing centres in Germany in 1988. 

Further sales centres open in France in 1993. By 1995 the company employs 190 people. In 1996 it acquires the second largest manufacturer of peptides in the world and forms Bachem California with a site in Torrance. 

 1998 - 2003 - Bachem goes public

Bachem company goes public and lists shares on the Swiss Stock Exchange. Further acquisitions include Peninsula Laboratories, Inc, based in California, and  Sochinaz SA, a Swiss-based manufacturer of active pharmaceutical ingredients.  By 2001, the company has 500 employees and sales reach 141 million CHF.

In 2003 the organisation is given a new legal holding structure to support its continued growth, which remains in place to this day. 

2007 - 2013 - acquisitions

Bachem acquires a brand by Merck Biosciences for ready-to-use clinical trial materials and related services. 

In 2013, together with GlyTech, Inc. Bachem announces the development of a new amino acid that can help to treat multiple sclerosis, with a world market of more than $4 billion. 

In 2015 it acquires the American Peptide Company (APC), which becomes integrated into Bachem Americas. 

2016 - 2019 - a global leader

In 2016 the group opens a new building dedicated to R&D projects and small series production in Bubendorf. With a total of 1,022 employees, the workforce exceeds the 1,000 mark for the first time in the company’s history. Sales are over the 200 million mark for the first time at 236.5 million CHF.
Bachem expands into Asia with the establishment of a new company in Tokyo called Bachem Japan K.K. 

By 2019 Bachem has a growing oligonucleotide portfolio - these are DNA molecules used in genetic testing, research, and forensics. It is hoped this will become a significant product range in the future. 

2020 - COVID-19

Despite the COVID-19 pandemic, Bachem secures its supply of active ingredients, and even increases it in critical areas. Sales exceed the 400 million Swiss franc mark for the first time, and  272 new employees are hired.  

2021 - a milestone anniversary

Bachem celebrates its 50th anniversary and position as a global leader in the manufacture of peptides. While it  remains headquartered in Bubendorf, the company employs 1,500 people at six locations worldwide. In the next five years there are  plans to continue expanding. 

Commemorating the company's anniversary, Kuno Sommer, Chairman of the Board of Directors, said: "Bachem's exceptional success story from a small laboratory to a global market leader is closely linked to Peter Grogg's values, and has been shaped by innovation, consistent quality and cost awareness, as well as by entrepreneurial vision."

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