July 1997 Topics
Doc Flock, Charting Party, Pingponging,
EBT, Fake EBT Transactions, Ghost Rider, Jumper, Add-On, Redact, Sanitize, Sink Testing, Two for One Sale, and Wave Therapy

 

Medical students rush to court
to change their names
before they receive their diplomas.
 

Fraud In Other Words
Professional Jargon and Uncensored Street Slang
by Larry C. Adams, CFE, CPA, CIA, CISA

 

Doc Flock
In their final weeks of medical school, a number of students flock into court to change their names before they receive their diplomas. The reason for that great rush is that a doctor cannot change his name after receiving his/her M.D. degree without invalidating that degree. This is their last window of opportunity to make a change. During an investigation of a person in a medical field, a skip tracer might target a period near the graduation to search for a name change.
Arizona Fraud Line, Phoenix, October 1994.

 

Charting Party
A medical staff gets together to review patients’ charts. They prepare written documentation to obtain the highest reimbursement from the insurance company. They may add services or items that were never provided.
Steve Wiggs, “Healthcare Fraud,” Western States Fraud Conference, Scottsdale, Arizona, October 12, 1993.

 

Pingponging
A scheme which refers patients to other doctors in a clinic in order to claim Medicare/Medicaid reimbursements for a “consultation” instead of for genuine treatment or observation of the patients.
Arizona Fraud Line, Phoenix, February 1994.

 

EBT
Electronics Benefit Transfer. A federal plan to provide public benefits electronically in all states by 1999. The plan will include welfare payments, food stamps, healthcare benefits, and Veterans Administration benefits. The goals of EBT are to cut the cost and time of mailing millions of checks and to prevent fraudulent use of checks. Plastic identification cards with magnetically encoded stripes, similar to credit cards, will be issued to the recipients of the benefits. The recipients will use the EBT cards to obtain cash from automatic teller machines (ATMs) at banks. EBT cards will be used at a point-of-sale terminal (POS) to pay for merchandise and services. The government will pay the banks a fee for the use of their ATM infrastructure, which is used to administer the programs. The banks are not required to open checking or savings accounts for the recipients. Several states are using EBT pilot programs for state benefit payments.
Arizona Fraud Line, Phoenix, January 1995.

 

Fake EBT Transactions
To deter the illegal sale or use of food stamps, EBT (Electronic Benefits Transfer) cards are issued to low-income persons. Food items purchased with an EBT card can be scanned and tracked. In a scam to match the technology, food product codes are manually entered by a merchant or photocopies of product bar codes are scanned. For about $200 of scanned transactions, the EBT cardholder  receives $100 cash and no merchandise.

 

Ghost Rider (Jumper, Add-On)
A person who falsely claims to have been on a train or bus involved in an accident, in an effort to collect money for alleged injuries. A “Jumper” is a person who joins the train or bus at the accident scene. An “Add-on” is a person who was never at the accident scene, but claims they were.
Arizona Fraud Line, Phoenix, June 1995.
Photo: http://www.nationaudio.com/News/DailyNation/250399/
News/images/B.jpg, April 7, 1999.

 

Jumper
A person who joins a train or bus at the scene after the mass transit accident occurs. Their intent is to file false injury claims.
Arizona Fraud Line, Phoenix, June 1995.

 

Add-on
A person who wasn’t at the scene of a train or bus accident, but claims they were injured there.
Arizona Fraud Line, Phoenix, June 1995.

 

Redact
To edit, compress, reduce, or select. From Latin, redigere. Ad vanum et irritum redigere; to make meaningless, null and void. Selected information often is blacked out, whited out, or deleted before copies of documents are provided to some persons during an investigation. Names, headings, notations, dates, numbers and cross-references might be obscured to delay or prevent disclosure of damaging or confidential information. Portions of government reports might be blacked out to protect classified information. In medical records, patients names and insurance claims numbers might be blacked out to protect the doctor-patient privilege.
John C. Traupman, The Bantam New College Latin & English Dictionary, Bantam Books, New York, 1995, p. 359.
Photo: http://www.appligent.com/products/product_families/
redaction.php, February 15, 2005.

 

Sanitize
To edit out the parts of a document or statement that might be damaging or sensitive in nature. To censor. Make less offensive. To rewrite an audit report or an investigative report and intentionally omit details, red flags, or important information.
Arizona Fraud Line, Phoenix, November 1994.

 

Sink Testing
A scam where a laboratory fails to perform the expected medical tests. They only pour the blood or urine specimens down the sink, but report normal results for the patient to avoid suspicion. Normal billings are submitted by the laboratory.
Steve Wiggs, “Healthcare Fraud,” Western States Fraud Conference, Scottsdale, Arizona, October 12, 1993.

 

Two for One Sale (2 for 1 Sale)
A food stamp is a government-issued coupon that is sold or given to a  low-income person and is redeemable for food. In a common scam, the person might resell $200 worth of food stamps to an unscrupulous grocer in exchange for only $100 cash and no food. Later the person uses the quick cash to purchase alcohol, cigarettes, or illegal drugs.

 

Wave Therapy
A doctor provides no medically founded therapy. While the patient lies on a table, the doctor merely waves his arms and hands above the patient, then announces the diagnosis or the cure. In another variation, the doctor gives a friendly wave in the direction of the patient in a parking lot or on a street, then charges the insurance company for a full office visit.
Steve Wiggs, “Healthcare Fraud,” Western States Fraud Conference, Scottsdale, Arizona, October 12, 1993.


 

ã Copyright 1997 Larry C. Adams.
All rights reserved.
 

Order the book - Fraud In Other Words
 Magazine Article Archive
Fraud Dictionary
Free update service