Case VIII: Chapter 5: Mystery Shopping and Snooping

 

Chapter 5: Mystery Shopping and Snooping

Matthew Dudley went to the Dining Room early the following morning.  He needed to talk to Señora Angostura before Beth arrived.  He was still reading the Wall Street Journal when Paloma emerged from the kitchen drying her hands on a dish towel.

“Señor Doc, it is always good to see you each morning.  It reassures me that somethings in life remain consistent and dependable. How are you today?”

“I am well, thank you, Señora. I have a very busy day ahead of me and will be away from the premises for much of it.  I wanted to talk to you and ask your advice on a delicate matter.”

“You know you can always talk openly with me.”

“The situation surrounding Mrs. Arthur’s murder affected many people here and particularly Mrs. Branch.  She puts on a brave face, but I suspect it is just to cover up just how sad she is inside.  I wish there were something we could do for her.”

“Do you think there are others here who are also hiding their true feelings.”

“I was thinking of Señora Barela.”

Paloma smiled. “I am pleased that you are becoming sensitive to people’s true nature.  I guess there are benefits of not living alone after all.”

“You are correct, as always, Señora,” Dudley admitted grudgingly. “Can you think of a way that we could get the two of them together to perhaps begin to build a friendship?”

“If you are asking me if I would arrange that, I would be happy to do it.  You are also becoming more subtle in your requests, Señor. Just so you know, I have invited both ladies to my kitchen to help me with menus for the Summer.  I believe both have something to contribute and it will be an opportunity to get to know each other better.”

“I apologize for trying to appear devious, Señora.  I should know by now to be direct with you.  You are much too perceptive for my feeble attempts.”

“Paloma gave Dudley an all-knowing look. I take no offense, Señor Doc. But, you must now do something for me and I will be very direct. You are no doubt aware that Señora Duncan has made a proposal to Mr. Blackburn and Ms. Elliott about their contracts and desired living arrangements.  They are pleased and will certainly accept.  That is a good outcome for everyone.  But, I would like you to speak candidly and forcefully to Señor Ramirez about his behavior toward Ms. Elliott.  Despite her repeated rejections of his advances, he refuses to take No for an answer.  He insists that she is just playing hard-to-get. It is time for him to stop bothering her altogether and I believe you are the appropriate person to deliver that message.  If not, I will have to ask Francisco to talk to him and that is not something I wish to do.”

“I understand completely, Señora.  You have my word that I will handle this.  There is no need to involve Lt. Garcia; he has more important things to attend to.”

Dudley and Paloma continued to exchange general pleasantries until Beth Ford arrived.  “I must be off, Señora.  You can be assured that I will speak to our Resident Romeo at soon as possible.  Buenos dias.”
Beth Ford had compiled a list of places to visit based on the initial information Minot Atkinson had developed.  She and Matthew Dudley stopped in the first place late that morning.  Dudley was uncomfortable with their deception and Beth took the lead.  The Medical Counselor at the first facility was dressed professionally despite the rather shabby appearance of the office and strip mall location. Her approach was courteous and thorough and she handled the difficult inquiries about personal and financial information with tact.  As Beth answered each question, the Counselor entered everything into a computer terminal on her desk.  After almost forty-five minutes of intense questioning, the Counselor said, “Well, that completes the information, Mrs. Jones.  It will take a few days for the State and Federal Governments to process things.  You will be hearing from us in the very near future.  I’m sure your aging mother will be greatly relieved to know that all of her future medical needs will be met.  Thank you again for choosing ACA Assist and coming by this morning.”

Beth suggested they stop for a light lunch as they got in her car.  “That way, we can review our first meeting and assess how we’re doing.  Is that agreeable with you?”

They ate quietly for a few minutes before Dudley said, “Beth, I know we are trying to understand what is actually happening with these so-called Agencies, but I am still a bit uncomfortable with the deception.”

“That is certainly understandable, Doc. It is for me as well.  I keep reminding myself, however, that our suspicion is that these Agencies are involved in a much greater level of deception and most likely with some of the most vulnerable people in our community.  That thought gives me the strength to do whatever I have to do to get to the bottom of this.  We’re committed to helping people and if we can prevent them from being taken advantage of, then I’m OK with what we’re doing.”

“Thank you, Beth.  What is the next location on our list?

For the next several hours Matthew Dudley and Beth Ford drove around Albuquerque and stopped in a variety of places which offered to assist people enroll in the healthcare systems provided through the Affordable Care Act.  At each, location, they became more efficient and more direct in their approach and questioning.   Late in the afternoon, they stopped in front of a store front in a strip mall with a large neon sign overhead that read ACA Insurance Associates.  They went in and were greeted by a well-dressed young man who introduced himself as a Certified Insurance Counselor. He offered them a bottle of water and directed them to a small cubicle.

The interview progressed much as the previous ones with a similar format and almost identical information requests.  Suddenly, Dudley stood up, motioned to Beth and said quite angrily, “Let’s get out of here.  I see no reason why this man has to ask all of these personal questions.  Why does he have to have all of this information?  I am very uncomfortable with telling this perfect stranger the most intimate details about my wife and our personal finances!”

It took Beth a moment to recover from Dudley’s outburst, but she quickly regained her composure and said, “Now, calm down, Father. I know this is a very trying time for you with all of Mother’s problems and the mounting medical bills, but this gentleman is just trying to help.  Please sit down and allow him to complete the interview.”

“Oh, alright, but I still don’t see why he has to have all of this information.”

The Counselor smiled and said, “I understand completely, Sir.  I personally find it very difficult and confusing at times myself.  I had many of the same questions when I was going through the training program to become certified. My understanding is that all of these questions are specified in the Act and that any omissions would cause your application to be rejected.  But, let me assure you that we do not share any of your information with any other Agency and that our computer network has the very latest security software.  If you’ll bear with me a few more minutes, we’re almost through.”

Beth could hardly contain herself, but waited until they had driven a few blocks before she pulled over. “I could kiss you!  That was brilliant!  Despite your outburst, that young man remained perfectly calm and simply waited you out. I think it is fair to say that we are dealing with a very sophisticated operation and that these so-called Counselors are well-trained, to say the least. I can understand why the information requests would be standard; that could be dictated by the Act. But, that wouldn’t explain why each of the Counselors we met used essentially the same script in dealing with us.”

“I do apologize for my outburst, but that young man just appeared too smooth for my taste.  My skin started to crawl and I just couldn’t contain myself any longer.”

“Well, it certainly provided us a deeper insight to the sophistication of this operation.  We still have no way to actually prove that these individual offices are connected other than our intuition.  Hopefully, Minot will discover something in her research.”

“I have several important repair projects that I must attend to tomorrow, but I’m available on Thursday if you would like to visit a few more places.  I suggest we try some different neighborhoods as well.  My sense of things is that these people will focus on the less educated and those who probably never had any form of health insurance.  If you agree, why don’t you pick a few places from Minot’s list and we’ll see what we learn.”

“That makes sense, Doc. And, if there is any connection between these places, waiting a day or two might cause something to develop.  I’ll pick you up at ten on Thursday.”

 

Dudley and Beth spent most of Thursday afternoon visiting several more so-called Agencies. When they stopped for gas at an Allsup’s station, Dudley noticed a stack of flyers on the counter as he paid for two bottles of water.   They were for a place in the neighborhood called ACA-R-Us.  “We have to go to this place,” he said as he got back in Beth’s car.  I’m almost afraid of what we’ll find and we may be over-dressed, but let’s do this one more and call it a day.”

The ACA-R-Us Agency was located a few blocks away in a strip mall. The office was a small store front situated between a Nail Salon and Title Loan Company.  “On second thought,” said Dudley, maybe this would not be necessary.  And, I’m not sure I could contain myself to sit through the entire interview.  I think we’ve seen enough in the past two days.  Our task now is to figure out what to do with what we’ve seen and heard.”

“Thank you.  I don’t think I could have handled this one either.  If you have no objection, I’d like to visit some of the Agencies in Rio Rancho over the weekend.    I’ve bribed my husband with a fancy dinner out and we can pose as a couple trying to enroll an aging parent.  We may even see what happens when we try to enroll ourselves.”

 

With a minimum of grumbling, Doug Ford accompanied Beth on their mystery shopping tour on Saturday. Their premise was that they wanted to enroll Doug’s mother in one of the programs available through ACA.  At the second site, they also asked about enrolling themselves since they claimed to be unemployed at the present.  At each location, the information format was nearly identical to what Beth and Dudley had experienced.  At their last scheduled visit, things got a bit complicated.  The Counselor did not greet them with the same sense of grace they had experienced previously.  In fact, she took a more aggressive approach almost immediately.  “It looks like you have already enrolled your Mother, Mr. Jones. I’m sure you’re aware that each person can only enroll once.  I hope you’re not trying to pull one over on us!”

Doug Ford was taken aback and wasn’t sure how to respond. Beth stepped in and touched him arm. “I’ll bet Father took our advice and enrolled Mother on his own.  I suspect he got tired of my nagging and got up from the TV and did the right thing.”

“Yeah. I’ll bet that’s what happened.  Sorry for the confusion.  We’ll be on our way. Thanks for catching that.  We wouldn’t want to try to fool the system, now, would we?”

As they drove away and toward Bernalillo, Doug looked over at Beth and smiled. “Damn, you’re good.  You’re a lot faster on your toes than I am! Let’s head over to The Range and I’ll buy dinner.”

“I still love you, Big Guy, even if you are a bit slow.  But, that proves something to me; these various Agencies are somehow connected.  I doubt seriously that any actual government-run program could connect the dots that quickly.”

Beth sat back in her seat and began to relax for the short drive into Bernalillo. Suddenly she sat up and pointed out the window. “Damn! Doc was right. There’s another Agency and it looks like it’s operating out of a van in front of the Casino!  These folks are really targeting the people who are most susceptible to this type of outright fraud.”

 

Minot enjoyed spending time with Emily Chang; she was intelligent and had a totally wicked sense of humor which delighted Minot.  Tonight, however, Minot was in a much more serious mood and was becoming increasingly concerned about what she had uncovered in her research.  But, she had not been able to access the information she wanted; everything seemed to be buried under layers of various organizational structure and ownership.

Emily picked up on Minot’s mood almost immediately. “OK, Sunshine, do you want to tell me what has your knickers in a knot or are you just going to sit there and be a snotty bitch all evening?”

Minot began with Mila’s report and then described her own investigations into the various agencies that had recently opened shop around Albuquerque.  “I am convinced, Emily, that there is something going on here.  My best guess is that this is a coordinated effort to steal identities from lots of unsuspecting people.  They are being told that they are signing up for healthcare benefits, but I don’t think that’s what’s happening at all. It’s really just a simple scam to steal identities.  Two things frustrate me.  One, my gut tells me that all or most of these operations are part of one larger organization, but I cannot seem to discover the connection.  Second, what really has me baffled is why the information hasn’t been used.  The families Mila interviewed said that there were no erroneous charges to their accounts, no mysterious withdrawals, etc.  Nothing!  In fact, one family didn’t even have a bank account or credit card; they did everything in cash. All that shows up is that each family appears to have used a large amount of medical services and equipment, which is also false.”

“Maybe, suggested Emily, the bad guys are just accumulating information and plan to use it later.  Or, they may be reselling it to some Nigerian Prince or Russian Oligarch for an entirely different type of scam.  There are lots of possible explanations.”

“I guess those are possibilities, but it’s a stretch, in my opinion.”

“Tell me again about these charges for medical equipment and services.”

“Both families said that they received quarterly statements for all of the services and equipment they used in the previous quarter.  But, in each case, neither family had used anything, no doctors’ visits, no wheelchairs, no oxygen tanks, nothing.  The statement said that everything was covered by insurance so the families just ignored it and assumed that the system was screwed up.”

“Well, as we know only too well, it is entirely possible for the system to be screwed up or account numbers confused, or any other of a host of bureaucratic nonsense. Why don’t you let me do some research on my own into these various organizations. I have ways of digging deeper into corporate records and filings and may be able to uncover some things that are not so obvious.  Have no fear, my Dear, I will find something.  In the meantime, why don’t you relax and let go of this for a while. Just open that delightful bottle of wine you brought.”

Minot tried to focus her attention on the other tasks that the Team had asked her to pursue, but she remained troubled.  One afternoon, while staring at her computer, she received a text message on her phone. “Meet me for coffee at The Flying Star on Central near UNM, Em.” Minot dropped what she was doing and hurried into town.   She found Emily Chang sitting at a table near the windows facing Central Avenue.

“I can tell you, began Emily, that most of the organizations on your list are connected and the trail seems to lead back to a single source.  The trail is very, very well disguised with multiple layers of organization and ownership, etc. There are even more so-called agencies involved, but I believe there is something more. I just cannot get past the very sophisticated web that has been created to hide things. And, I still can’t figure out why the information is being collected in the first place.”

“So, you’ve confirmed my suspicion that there’s something fishy going on.  That is reassuring, but how can we find out what is behind all of this?  People don’t just collect personal confidential and not do anything with it.”

Emily smiled. “I think it’s time to call The Doctor.”

“What? Don’t tell me this little project has made you ill.”

“No. Let me tell you a story that’s before your time and mine for that matter, but I’m sure you are aware of the urban legend that Microsoft actually started here in Albuquerque.”

“I’ve heard that story, but I’ve always dismissed it as just that, urban legend.”

“Well, Bill Gates and his original team were holed up in a motel here on Central writing code back in 1977. The story goes that Gates was arrested for some minor traffic BS; you can even Google his mug shot.  Anyway, they packed it in and headed west to Washington; except for one guy who stayed.  Over the years, he became completely invisible. For all intents and purposes, he doesn’t exist; he’s that far underground. Completely off the grid.  He exists only by legend and no one even knows his name; he’s simply referred to as The Doctor.  Without going into any detail, he and I became acquainted several years ago during a project of mutual interest.  If anyone can trace this trail back to its ultimate source or sources, it is him.  I think a call to him would be appropriate at this point.”

“Wow. I’d like to introduce him to the Team or at least Beth Ford.  Can you arrange a meeting?’

“No can do.  In fact, if I tell you any more, I’d have to kill you!”

“C’mon Em, you can trust me.”

“That’s not the point.  You’ll just have to trust me and forget we ever talked about this.  Minot, I believe in what you’re doing and I also believe you’ve stumbled onto something much bigger than you can imagine. Let me handle this.  I promise to tell you anything and everything that affects your work and the Community Assist initiative.  Gotta go.”

Minot Atkinson sat at the table for a long while.  She hadn’t touched the coffee or the pastry Emily had bought for her.  She trusted Emily Chang explicitly, but could not help but wonder what she had meant by something bigger than you can imagine.   It was not unlike Emily to have an air of intrigue about her, but her reference to this mysterious character called The Doctor was both exciting and disturbing.  Minot realized that she had no choice but to wait for Emily’s call, which she knew would come … eventually.

 

 

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