An empty medical office in Crystal Lake, Illinois, has raised questions over possible phantom billing after an insurer was charged $500 for a laboratory test that a patient said she never received.
Katie Duda noticed the charge on an Explanation of Benefits letter from Blue Cross Blue Shield of Texas. She said the name of the provider, Niyraa LLC, was unfamiliar, prompting her and her mother to visit the company’s listed premises.
They found an unlocked office in a strip centre with no staff present. A sign on the door instructed visitors to leave mail inside, while the premises appeared to be vacant.
Over five visits across several months, reporters found thousands of unopened letters inside, many addressed to Niyraa LLC and sent by different Blue Cross Blue Shield entities. The correspondence was initially stored in postal bins at the front desk before being moved into black and white rubbish bags at the rear of the office.
Crystal Lake police, the FBI and US Postal Service inspectors were alerted after concerns were raised that the mail could contain patients’ personal information. The letters remained at the premises during repeated visits, despite the warnings.
The office displayed the name Mohammed I Quadri on its external and internal signage, as well as on current laboratory certificates hanging on the walls. However, attempts to contact him by email, text message and telephone were unsuccessful.
Quadri was also not found during a weekday visit when the laboratory was supposed to be open. The owner of the shopping centre said he had not seen Quadri for months, although the laboratory continued to pay rent.
Brittany Serby, who runs a clinic nearby, said she had never seen Quadri and was worried by the volume of mail in the office.
“It was real troubling to learn,” she said.
James Scordo, a certified fraud examiner and forensic accountant, inspected the premises and found clean laboratory equipment, unopened packages of vials and other supplies that appeared to have been left untouched for months. Mail had spilled on to the floor.
“Each one of those could be a potential victim,” Scordo said.
He said patients’ private information could be exposed and warned that, if tests had not been carried out, their medical records and future ability to obtain insurance could be affected.
“It appears this is a front for a fraud scheme. I mean, it has all the signs,” Scordo said.
He suggested the office could be involved in phantom billing, whereby an insurer pays for medical services that patients did not receive without their knowledge.
The US Postal Service inspector general is investigating. The FBI said it had alerted local authorities and sanitation crews about the mail in case it was discarded.
In recent weeks, neighbouring businesses sent photographs showing that the rubbish bags filled with mail had been removed, although it was not known who took them. More correspondence had subsequently been delivered and was found on the front desk.
As recently as September 16, no mail was visible from outside the premises, but the door remained unlocked and the instruction to leave mail inside was still displayed.
Blue Cross Blue Shield said it could not comment on its relationships with individual providers.
