Dr. Sievers' RHHC Medical Practice - Operations & Website

[concernedmother]

Wonder how many people found their self in the same boat thinking she still took medicare? Scamming the patients.

 

[Lilibet]

So is it safe to say that these services were not for real patients? Curious.

I haven't had time today to catch up with you guys, but have confirmed the following if it helps:

1. Teresa Sievers is still, today, listed as a Medicare provider.

2. For Calendar Year 2013 (the last data set available), TS was paid by Medicare approximately the following (you guys will have to do the math!):

For 81002 Urinalysis 11 claims x $3.46
For 82270 Stool analysis 52 claims x $4.42
For 93000 Routine EKG 33 claims x $14.60
For 96372 Injection 539 claims x $19.47
For 99203 New patient 30 minutes 17 claims x $69.97
For 99211 Established patient 5 minutes 41 claims x $15.60
For 99212 Established patient 10 minutes 15 claims x $26.90
For 99213 Established patient 15 minutes 119 claims x $49.32
For 99214 Established patient 25 minutes 278 claims x $74.10
For 99215 Established patient 40 minutes 182 claims x $107.01
For G0101 Cervical or vaginal cancer screening 24 claims x $33.70
For G0102 Prostate cancer screening 17 claims x $11.88
For G0439 Annual wellness visit 67 claims x $112.80

 

[AZlawyer]

So is it safe to say that these services were not for real patients? Curious.

Wait, what? I definitely missed something. I thought maybe the theory was that Medicare was being billed but patients were being told "we don't take Medicare" thus TS's practice got paid Medicare rate plus cash from the patients? But like I said I haven't read much on here so may have misunderstood.

 

[Maxine2U]

M2. Good job. We are glad you are back. What are your thoughts about this whole thing? Thanks

Hi Dexter, love your SN! I think that it's very likely that there was some kind of book cooking going on with MS and CWW. I also think there was other criminal activity as well, aside from murder :jail: Maybe drug dealing? I think TS was killed because she found out about something and had been suspicious for a while. I think she was embarrassed, as so many domestic abuse victims are, about what life was like with her husband and that she was in denial until just before she was killed. I hope I'm wrong about that last part.

It's all very sad and my heart goes out to her daughters.

 

[Orgona]

So is it safe to say that these services were not for real patients? Curious.

To me this only means that in 2013 dr Theresa Sievers was stil treating patients who were on Medicare. Nothing more nothing less IMO.

 

[Lilibet]

Wait, what? I definitely missed something. I thought maybe the theory was that Medicare was being billed but patients were being told "we don't take Medicare" thus TS's practice got paid Medicare rate plus cash from the patients? But like I said I haven't read much on here so may have misunderstood.

I get an Explanation of Benefits from Medicare and my supplemental insurance. If I'm paying attention, I would notice that I had already paid for something and Medicare was also paying. That's why I wondered if they were billing for fake patients. Isn't it possible to buy lists of dead peoples' Medicare numbers? I've seen something like this covered on 60 Minutes...huge fraud...in FL IIRC. Medicare pays millions in fraudulent claims. They don't check on stuff.

 

[AZlawyer]

I get an Explanation of Benefits from Medicare and my supplemental insurance. If I'm paying attention, I would notice that I had already paid for something and Medicare was also paying. That's why I wondered if they were billing for fake patients. Isn't it possible to buy lists of dead peoples' Medicare numbers? I've seen something like this covered on 60 Minutes...huge fraud...in FL IIRC. Medicare pays millions in fraudulent t claims. They don't check on stuff.

Oh, OK. Could be. I get my EOBs online and literally never look at them unless I get a bill that makes me say, "Now wait just a damn minute." lol

 

[human]

I get an Explanation of Benefits from Medicare and my supplemental insurance. If I'm paying attention, I would notice that I had already paid for something and Medicare was also paying. That's why I wondered if they were billing for fake patients. Isn't it possible to buy lists of dead peoples' Medicare numbers? I've seen something like this covered on 60 Minutes...huge fraud...in FL IIRC. Medicare pays millions in fraudulent t claims. They don't check on stuff.

We know there is a ton of Medicare fraud. But I don't get it. I have very little in terms of services so maybe that is why I notice. It is very clear what is charged p, what is paid out and what you owe,

But if you are quite elderly and have a lot of services, maybe you don't notice an extra charge here and there.


These EOB have to be mailed somewhere. A physical address would seem hard to pull off. An email one?

How does the address part work

 

[Lilibet]

I'm not saying that fraud was happening in Dr. Sievers' practice, but it's a huge thing all over. So why couldn't it happen right under her nose? Read this link from June 19 of this year...and weep.

Federal agents have arrested 243 people — including 46 doctors, nurses and other medical professionals — who are accused of running up more than $700 million in false Medicare billings. Charges range from fraud and money-laundering to aggravated identity theft and kickbacks.

http://www.npr.org/sections/thetwo-...43-charged-in-million-dollar-medicare-schemes

 

[Nana46]

I always thought Medicare was very very careful in having duplicate claims filed???? At least I don't think they would pay again if they had already paid a legitimate claim....they question it I believe and you would get notification of this or at least according to my eob's they stay pretty much on top of stuff....of course I am a legitimate patient,lol......at least I think I am and I would sure pick up on if someone tried to bill twice for the same service....now re-submitting if the claim is denied I could see. IMO.

 

[DexterMorgan]

Did Ts know that the books were cooked?

She seems like the type of person that will check all finances. So I doubt ms thought that she wouldn't find out at first.

So are we saying she knew. Or died because she found out. Or was killed for other reasons.

 

[Lilibet]

We know there is a ton of Medicare fraud. But I don't get it. I have very little in terms of services so maybe that is why I notice. It is very clear what is charged p, what is paid out and what you owe,

But if you are quite elderly and have a lot of services, maybe you don't notice an extra charge here and there.


These EOB have to be mailed somewhere. A physical address would seem hard to pull off. An email one?

How does the address part work

A P.O. BOX or even a real address could work. Medicare is churning out payments. They aren't stopping to cross-reference anything unless someone notifies them of fraud.

I'm usually careful about checking my EOB's but I'm several months behind. I think that's what fraudsters are counting on. And you're right that the very elderly with a lot of services might not notice extra charges. I am never billed because my supplementary insurance picks up the 20% so I wouldn't notice unless I kept track.

I keep meaning to ask you how you get Medicare if you don't live in the U.S. I thought expats were not able to do that. Has something changed?

 

[Bobbywoo]

I've been lurking the past few days after feeling uncomfortable on another thread. I said publicly I wasn't going to use this forum anymore. :blushing: I CAN'T STAY AWAY!!! And people like NIN is why! Holy cow I thought I had read everything on WS about Dr TS but apparently not! This is crazy!!! :scared:

Wow. Wow. Wow.

Right??? Every once in a while someone like Madtownbucky will come on after lurking, drop a bombshell and drop back out of sight. And someone as fantastic as NIN will keep that very important post from being lost in the shuffle. I have read NOTHING derogatory or alarming about MS until this post. NOTHING. He hung close to criminals yet had no record. Always smiling and even tempered. Until....one bravo sole came forward to tell their experience, then Amazonrain, then Southwestfl with her experience (which I may find more objectionable than her?). This group is fantastic!

 

[IQuestion]

I haven't had time today to catch up with you guys, but have confirmed the following if it helps:

1. Teresa Sievers is still, today, listed as a Medicare provider.

2. For Calendar Year 2013 (the last data set available), TS was paid by Medicare approximately the following (you guys will have to do the math!):

For 81002 Urinalysis 11 claims x $3.46
For 82270 Stool analysis 52 claims x $4.42
For 93000 Routine EKG 33 claims x $14.60
For 96372 Injection 539 claims x $19.47
For 99203 New patient 30 minutes 17 claims x $69.97
For 99211 Established patient 5 minutes 41 claims x $15.60
For 99212 Established patient 10 minutes 15 claims x $26.90
For 99213 Established patient 15 minutes 119 claims x $49.32
For 99214 Established patient 25 minutes 278 claims x $74.10
For 99215 Established patient 40 minutes 182 claims x $107.01
For G0101 Cervical or vaginal cancer screening 24 claims x $33.70
For G0102 Prostate cancer screening 17 claims x $11.88
For G0439 Annual wellness visit 67 claims x $112.80

APPROXIMATELY $70,000 ..... But, THAT IS JUST FOR SERVICES....What are the totals for Medicare D scripps....

 

[Wyle_E_Coyote]

Did Ts know that the books were cooked?

She seems like the type of person that will check all finances. So I doubt ms thought that she wouldn't find out at first.

So are we saying she knew. Or died because she found out. Or was killed for other reasons.

I dunno. .. we've had a couple of insiders say that ms controlled the finances and that ts allowed him to handle all that so she would be able to focus on other things.

Sent from my SM-G900V using Tapatalk

 

[Lilibet]

I always thought Medicare was very very careful in having duplicate claims filed???? At least I don't think they would pay again if they had already paid a legitimate claim....they question it I believe and you would get notification of this or at least according to my eob's they stay pretty much on top of stuff....of course I am a legitimate patient,lol......at least I think I am and I would sure pick up on if someone tried to bill twice for the same service....now re-submitting if the claim is denied I could see. IMO.

I hear you, but I'm not talking about duplicate claims. I'm talking about totally bogus claims for services never rendered as described in the article from NPR I linked. I'll have to go googling some more, but I think the patients didn't exist. They used Medicare numbers no longer in use. But by the time Medicare caught up with this, the fraudsters had moved on to another location.

I'm not saying this was happening in TS's practice. But it could have been without her knowing it. She was the doctor. Doctors aren't involved in billing, although there are dishonest ones who were just arrested according to the link. MS and CWW could have done this easily. Not all the people arrested are geniuses. They just knew how to work the system and took the risk.
JMO

 

[NSS]

To me this only means that in 2013 dr Theresa Sievers was stil treating patients who were on Medicare. Nothing more nothing less IMO.

.....The patient who posted about her experience says she was a patient 3 years ago (2012) and was told they did NOT accept medicare.

 

[Bobbywoo]

.....The patient who posted about her experience says she was a patient 3 years ago (2012) and was told they did NOT accept medicare.

Make her pay the full amount then charge it to medicare....baaaabaaam!

 

[Lilibet]

APPROXIMATELY $70,000 ..... But, THAT IS JUST FOR SERVICES....What are the totals for Medicare D scripps....seems to me I say over $300,000 in scripps being filled under that name....but I'll be darned if I can't find it now!

That's about the figure I came close to without checking the smaller items.

Here are the details from the FBI about the busts in June in FL. Medicare Part D (drugs) was a large part of this.

https://www.fbi.gov/miami/press-rel...t-national-medicare-fraud-takedown-in-history

 

[observation]

Well, this thread is certainly on topic and makes for great reading. There are so many excellent posts with gobs of information from incredible sleuthers. Depending on when TS decided not to accept Medicare, it's a really tough call. Lots of docs will opt-out of accepting Medicare since they don't pay nearly what they can make from private patients. Having a holistic practice in FL with potential patients that come and go (meaning retire there and have other homes as well) willing to pay a good doctor big bucks, may be A reason she switched. The important timing of when this change from a participating to a non- participating physician would be needed to help with our understanding of this as a possibility.


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