Published Nov 25, 2012
wish_me_luck, BSN, RN
1,110 Posts
Do insurance companies ever hire nurses to investigate health insurance fraud?
The way it's looking, I am probably going to end up in either public/community health or mental health or some combination of both because those are the areas I am passionate about. But, I am finding while navigating the mental health system, that some providers are not good and some are saying they are doing stuff they aren't doing (like certain services they are not providing). Last I checked, that's insurance fraud. I did some looking online and found out that insurance fraud is huge problem, especially in mental health. That's incredibly unfortunate because 1) these are extremely vulnerable people and are easily taken advantage of, 2) they often times are on a limited income (do not have much money at all due to unemployment whether because of of a stigma against the mental illness or difficulties holding a job due to the mental illness), 3) People with mental health problems need a decent healthcare provider to prevent complications (i.e. continuous hospitalization or suicide). I can say from experience how draining and anxiety provoking it is when you go to a mental health care provider and you are paying them to help you and you leave the office feeling worse than when you went in (I want to do something big and great with my life and I actually had a therapist once tell me that it would be too stressful for me to do something big in life due to my mental illness. Yeah, needless to say, I got rid of that therapist) or when you pay psychiatrists and you received nothing--no meds or therapy.
I think it would be cool to work as a fraud investigator as needed, not a regular job. So, anyone ever heard of this?