Dr. Sievers' RHHC Medical Practice - Operations & Website

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I guess I am not understanding how a fake account would benefit an office that takes cash only. What "fake person" is going to pay a bill if they don't exist?
If they are not billing insurance, I am missing where this would be a profit-producing scam. You can create a fake account, but someone has to be billed.

I am thinking he is just stalling in getting records because he doesn't want to do the work. He knows he is potentially implicated soon and has been spending time with kids, etc. He probably also does not want to go back in that office and face either the sadness of losing TS or the guilt of being involved.



I agree with what you're saying, what would be the point? Probably the only way it would be helpful is if trying to hide income from other sources to make that income legitimate. Now that could be something here.
 
I thought about that.. But in order to fill a controlled substance prescription in Florida, you need to present ID. The only scenario that could happen, in this case, would be if they were being filled in Missouri (I'm not sure what the law is there regarding controlled substances).

I'm not either.

I will say that I did live in Fenton for a few years and pseudoephedrin is very hard to find. Some cities require a rx to obtain it even. I would literally stress out when I got sick and needed sudafed because it was such a pain to find and its the only thing that helps me.
 
What if a separate bank account, for the practice, was used to make deposits of drug money. The practice would have to report it as income and pay taxes on it, but TS wouldn't have to know about it. She handled the patients, he handled the books. Someone could be paid for IT services through the separate account. This was a cash business. It would look above board on paper. TS was the only DR in the practice: No TS, no practice. She would NEVER be involved in ANY of this.
JMO
 
What if a separate bank account, for the practice, was used to make deposits of drug money. The practice would have to report it as income and pay taxes on it, but TS wouldn't have to know about it. She handled the patients, he handled the books. Someone could be paid for IT services through the separate account. This was a cash business. It would look above board on paper. TS was the only DR in the practice: No TS, no practice. She would NEVER be involved in ANY of this.
JMO

Yes, that would/could be a purpose for fake accounts, legitimizing on paper funds or income received from illegitimate sources.
 
IDK, but after I hung up with my daughter I started thinking...

From what I can tell, RHHC was a fairly small practice, considering patient load. I never have been able to justify the the necessity of having enough for CWW to do re IT work for them. So, I started wondering if maybe he wrote them their own EMR program. I know buying from a provider can be expensive. Not just the initial investment which includes a few free tech support calls IIRC, her company sold & installed the program, spent 3-5 days training staff (depending upon how large the practice/staff) and included 5 free tech support service on-site calls. After that, charges incur for on-site calls and they aren't cheap. So maybe CWW developed their own program for documenting records? At least that would help justify why he was needed so often. I think this could work especially since they operated on a "cash only" basis. I don't know if it would've worked if they had to submit insurance claims though.

Just a thought...

ETA: IF that is what happened, that would explain the problems accessing the back-up. :angel: Also, what CoolJ said re. deleting stuff if he thought something hinky was about to be found (obviously prior to being arrested).

IF CWW wrote the EMR program for the practice, I wonder if this would open a can of worms re: HIPAA Privacy and Security. I know TS does not bill insurance, but IMO the practice would still be subject to HIPAA Privacy & Security rules governing electronic transmission of information. "Health Care Providers. Every health care provider, regardless of size, who electronically transmits health information in connection with certain transactions, is a covered entity" http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html

What I'm getting at is that if I were TS, I'd want to use well-known EMR software vendor from a risk management perspective with regard to HIPAA. Unless CWW justified his 'job' by ensuring adequate firewalls, data backup, encryption measures were in place, regularly. It just seems like a no-brainer to me, if you're going to use EMR, you would NOT want to host the data on your own servers. If you choose to host data on your own servers, you need to worry about drafting and implementing polices re: back up data, security. You can't just have those servers sitting in the office where anyone could swipe them.

So many questions. Most importantly, we should start with what kind of EMR program was being used, and if a program was designed and maintained by CWW, where are the written policies outlining procedure and privacy protections required by HIPAA? I'm guessing there are no written polices or if there are, those policies were not followed because obviously, MS did not properly back up the data.
 



I guess I am not understanding how a fake account would benefit an office that takes cash only. What "fake person" is going to pay a bill if they don't exist?
If they are not billing insurance, I am missing where this would be a profit-producing scam. You can create a fake account, but someone has to be billed.

I am thinking he is just stalling in getting records because he doesn't want to do the work. He knows he is potentially implicated soon and has been spending time with kids, etc. He probably also does not want to go back in that office and face either the sadness of losing TS or the guilt of being involved.



The fake person wouldn't pay the bill, but the creation of a fake person would create a (seemingly legitimate) paper trail for illegal profits claimed by the business as income. It might not even be a fake patient, it could be a real patient but a fake bill, one that was never sent to the real patient but "paid" in cash and claimed by the practice or deposited into a bank account associated with the practice and/or MS.

I would assume that if you had to delete "fake records" attributed to or within the real patient record, a simple transfer of medical records wouldn't be so simple anymore.
 



I guess I am not understanding how a fake account would benefit an office that takes cash only. What "fake person" is going to pay a bill if they don't exist?
If they are not billing insurance, I am missing where this would be a profit-producing scam. You can create a fake account, but someone has to be billed.

I am thinking he is just stalling in getting records because he doesn't want to do the work. He knows he is potentially implicated soon and has been spending time with kids, etc. He probably also does not want to go back in that office and face either the sadness of losing TS or the guilt of being involved.



If I were innocent, I'd still be reeling from the loss of my love, my life partner, parent of my children, best friend, confidant, business partner. He was criticized for trying to keep the business going by trying to find another doctor. Lots of people cope with a loss by putting one foot in front of the other and plodding along trying to keep things as "normal" as possible especially when there are small children. It's sometimes easier than the constant reminder of the loss of a spouse every single minute of every day. Focusing on the business would help some. Imagine the added devastation of the family losing their home after losing their wife and mother. The practice was the source of income, the income paid the bills. He could be trying to take care of business, but be completely unable to mentally or emotionally. Sometimes it feels as though it's one thing after another falling on your head every time you think you're making progress. He may be dragging his feet getting the records out because that's just one more setback or it feels like it's admitting failure that he couldn't keep the business going. He knows more than anybody that TS can't be replaced, but the practice was already in place and if he got even a temporary doctor in, it could continue to produce an income of some sort until he either found a permanent doctor or sold the practice and got a job somewhere else.

Fake accounts are not meant to benefit the practice at all. It's a method of "skimming" money so that it's like it never existed and it goes to you personally. The point of ghost accounts is that they don't exist on the books, but in the ethernet so to speak. They are created solely to collect money from Medicare for example. Like bookkeepers or business owners keeping a duplicate set of books; cooking the books. Obtaining money that doesn't have a paper trail if done correctly. Or people collecting welfare under multiple fake names. The money is real, the accounts or people or patients are not. It doesn't even have to be fake people or ghost accounts, it could also be done by piggybacking off of real people's records, but collecting money from the source, but never intended for the real patient/person. It can also be done by creating ghost vendors. So many sneaky ways to siphon money.

CWW could have done this through the practice without anyone in the office ever knowing unless he made a mistake or someone on the paying end got suspicious and contacted TS directly. It happens sometimes that the first clue an owner might have is a contact from the IRS requesting an audit.
 
the fake person wouldn't pay the bill, but the creation of a fake person would create a (seemingly legitimate) paper trail for illegal profits claimed by the business as income. It might not even be a fake patient, it could be a real patient but a fake bill, one that was never sent to the real patient but "paid" in cash and claimed by the practice or deposited into a bank account associated with the practice and/or ms.

I would assume that if you had to delete "fake records" attributed to or within the real patient record, a simple transfer of medical records wouldn't be so simple anymore.

yes....
 
If I were innocent, I'd still be reeling from the loss of my love, my life partner, parent of my children, best friend, confidant, business partner. He was criticized for trying to keep the business going by trying to find another doctor. Lots of people cope with a loss by putting one foot in front of the other and plodding along trying to keep things as "normal" as possible especially when there are small children. It's sometimes easier than the constant reminder of the loss of a spouse every single minute of every day. Focusing on the business would help some. Imagine the added devastation of the family losing their home after losing their wife and mother. The practice was the source of income, the income paid the bills. He could be trying to take care of business, but be completely unable to mentally or emotionally. Sometimes it feels as though it's one thing after another falling on your head every time you think you're making progress. He may be dragging his feet getting the records out because that's just one more setback or it feels like it's admitting failure that he couldn't keep the business going. He knows more than anybody that TS can't be replaced, but the practice was already in place and if he got even a temporary doctor in, it could continue to produce an income of some sort until he either found a permanent doctor or sold the practice and got a job somewhere else.

Fake accounts are not meant to benefit the practice at all. It's a method of "skimming" money so that it's like it never existed and it goes to you personally. The point of ghost accounts is that they don't exist on the books, but in the ethernet so to speak. They are created solely to collect money from Medicare for example. Like bookkeepers or business owners keeping a duplicate set of books; cooking the books. Obtaining money that doesn't have a paper trail if done correctly. Or people collecting welfare under multiple fake names. The money is real, the accounts or people or patients are not. It doesn't even have to be fake people or ghost accounts, it could also be done by piggybacking off of real people's records, but collecting money from the source, but never intended for the real patient/person. It can also be done by creating ghost vendors. So many sneaky ways to siphon money.

CWW could have done this through the practice without anyone in the office ever knowing unless he made a mistake or someone on the paying end got suspicious and contacted TS directly. It happens sometimes that the first clue an owner might have is a contact from the IRS requesting an audit.

I understand the plausibility of skimming and think if there was any opportunity to do that, CWW would have definitely be doing that. I actually believe that there had to be some kind of scam going on. It happens all the time. Especially creating fake vendors, creating fake invoices, fake bank accounts,etc.

I was commenting on creating fake patient accounts either for billing purposes or prescriptions. I see where it could be used for money laundering...just trying to wrap my mind around whether I believe that was the purpose. If MS had a problem with CWW participating in illegal activities while in his condo in MO, I find it hard to believe he would participate in such a deal. But, nothing in this case is out of the question in my mind. I am open to all possibilities.

Looking at her Medicare billing info from 2013, I did not see anything out of the ordinary. In fact, her overall reimbursements were quite low compared to other physicians. I guess this reinforces the low amount of patients that she accepted Medicare from and the fact that she spent more time with patients during longer office visits.

Just my opinion.
 
In order to truly skim money or gain access to prescribed meds for the purpose of meth manufacturing while staying under the radar; You really need straw patients and or straw vendors that are down with the plan. Jmo
 
MICHAEL BRAUN, MBRAUN@NEWS-PRESS.COM 4:48 p.m. EDT October 6, 2015

A notice sent to patients of slain Estero physician Teresa Sievers on Monday afternoon by her office manager and husband Mark Sievers blames IT and email issues for patient records problems.

<snip>....


"My computer and networking equipment that I have used to access and send medical records has not been in my custody since the death of my wife, Teresa. When I go to the office I seem to encounter the press, thus making it much more difficult," he said in the notice.

<snip>....

"I am sorry for the delay in sending this update. I will be sending more updates as they develop. My daughters and I greatly appreciate your support and prayers during this tragic time in our lives," he said.

http://www.news-press.com/story/news...ords/73433466/
 
I understand the plausibility of skimming and think if there was any opportunity to do that, CWW would have definitely be doing that. I actually believe that there had to be some kind of scam going on. It happens all the time. Especially creating fake vendors, creating fake invoices, fake bank accounts,etc.

I was commenting on creating fake patient accounts either for billing purposes or prescriptions. I see where it could be used for money laundering...just trying to wrap my mind around whether I believe that was the purpose. If MS had a problem with CWW participating in illegal activities while in his condo in MO, I find it hard to believe he would participate in such a deal. But, nothing in this case is out of the question in my mind. I am open to all possibilities.

Looking at her Medicare billing info from 2013, I did not see anything out of the ordinary. In fact, her overall reimbursements were quite low compared to other physicians. I guess this reinforces the low amount of patients that she accepted Medicare from and the fact that she spent more time with patients during longer office visits.

Just my opinion.

I don't disagree with you - and pay no attention to my rambling- I began addressing something specific in your post and got sidetracked by my own thoughts up there and it should have been under a different post quote. :doh: at myself, lol.

Do you think he could have used HER information in regard to setting up bogus doctor accounts for purchases?

I just think of all the information that a bent IT guy has access to. I think TS was so busy there were many opportunities for him to use as a jumping off point for 1) prescription ingredients, 2) skimming, 3) laundering.

I'm soooo looking forward to knowing what exactly was going on there.
 
In order to truly skim money or gain access to prescribed meds for the purpose of meth manufacturing while staying under the radar; You really need straw patients and or straw vendors that are down with the plan. Jmo

How so?
 
I thought about that.. But in order to fill a controlled substance prescription in Florida, you need to present ID. The only scenario that could happen, in this case, would be if they were being filled in Missouri (I'm not sure what the law is there regarding controlled substances).


I'm going to bet MO laws are stringent. Some counties will not even sell pseudophed <?> without a scrip. And some make lists of everyone purchasing. This was due to the large amount of meth manufacturing in the area. Our area had a task force that cross referenced all purchases and that got the ball rolling for first the meds going behind the counter and finally the scrip changes.

*I thought I used "reply with quote" to #517--sorry
 
i think CWW and MS were skimming off of the top of TS' practice, she started to become aware and started checking into things. why was she working has @-- off and there's always a shortage of $$. she starts poking around and they know their gig is up. i also think she was about to boot him out and MS knew it. at CWW's wedding they started planning it. CWW's direct motive was to carry out MS' wishes and to get $15,000 cash - $10,000 to **** JR to do the dirty work.

MS is thinking, 'i MADE her and she is going to kick ME out!". He gets all the $, house and kids. Totally all just my opinion.
 
i think CWW and MS were skimming off of the top of TS' practice, she started to become aware and started checking into things. why was she working has @-- off and there's always a shortage of $$. she starts poking around and they know their gig is up. i also think she was about to boot him out and MS knew it. at CWW's wedding they started planning it. CWW's direct motive was to carry out MS' wishes and to get $15,000 cash - $10,000 to **** JR to do the dirty work.

MS is thinking, 'i MADE her and she is going to kick ME out!". He gets all the $, house and kids. Totally all just my opinion.

.....and a good opinion at that, Pesky
 
"Q: How easy is it to create fake accounts?
A: Very simple. Especially easy if no insurance is being billed." quoting beach'es daughter

This is what I thought and we could be on to something!​




"Ghost accounts, ghost patients, ghost employees"....it has happened to all different types of businesses. And if you are of criminal mindset with a lot of time on your hands (aka no real job) you will find a system. Many have been tried before & some have gotten away with it.
"Cooking the books" & "keeping two sets of books" are some other systems utilized.

And then we can also get into the various systems of prescription fraud....lots of ways to do that too!

Where there is a will and a psychopath, there's a way...
 
The fake person wouldn't pay the bill, but the creation of a fake person would create a (seemingly legitimate) paper trail for illegal profits claimed by the business as income. It might not even be a fake patient, it could be a real patient but a fake bill, one that was never sent to the real patient but "paid" in cash and claimed by the practice or deposited into a bank account associated with the practice and/or MS.

I would assume that if you had to delete "fake records" attributed to or within the real patient record, a simple transfer of medical records wouldn't be so simple anymore.

.... And that fake patient ("ghost account") needs a lot of pain medication prescribed, of course

One fake ID coming right up, sir!
 

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