Calif. Spa Charged In Medical Billing Fraud
By Tracey Kaplan, San Jose Mercury News | |
McClatchy-Tribune Information Services |
Meanwhile, the owners and two employees of San Jose Chiro on
"Non-therapeutic massages, facials, manicures and pedicures are great, but they are not medical treatments," prosecutor
Authorities on Wednesday arrested San Jose Chiro chiropractor
Based on a tip, authorities began an investigation of San Jose Chiro at the end of 2012, which they dubbed "Operation Nail Care." An investigator from the Santa Clara County District Attorneys Office visited the spa eight times and received eight free manicures and pedicures. Her insurance company was billed
Large as the insurance fraud appears, it's just the tip of the iceberg.
"Insurance crimes are a multi-billion drain on
Kwok said it's unclear whether customers knew of the fraudulent billing, though it seems likely many did, since even the best insurance policies don't usually cover nail care. About 90 percent of the spa's business was fraudulently billed, Kwok said.
However, some insurance companies do cover massage. One customer who got massages at San Jose Chiro complained on Yelp about a month before the arrests that the spa was no longer willing to bill her particular insurance company.
"The only reason why I even come here is because my insurance covers it, so it's free," the woman griped in the online post. "I'm just gonna go elsewhere and pay for a better massage than having a free one where the service is mediocre."
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