Healthcare Fraud

Healthcare Fraud

What is healthcare fraud?

It is important to know and understand what healthcare fraud is when you are a part of the healthcare field on any level and in any capacity.  Healthcare fraud is the act of giving false information about a patient and their services to insurance companies in order to get more money from them.  This can affect anyone who directly provides services and those who are responsible for reporting and billing healthcare services.  Healthcare fraud can also affect our patients.

What are the common forms of healthcare fraud?

  • Billing for incorrect services that were provided to a patient.
  • Billing for more expensive services.
  • Stating an incorrect diagnosis.
  • Providing services that are not medically necessary.

Why is healthcare fraud damaging?

  • Medical identity theft can occur because of it healthcare fraud.
  • Patients can physically be at risk when receiving unnecessary healthcare services.
  • Some patients who have private insurance can have their coverage used up by false claims and they then might not be able to receive services when they truly need them.

What can you do about healthcare fraud?

  • Read through your insurance claims carefully.
  • Protect your insurance card like your social security card. Only provide the information to trusted sources, not over the phone or to any solicitors.
  • Contact your insurance company if you suspect any healthcare fraud.
  • Be honest about the services you provide.
  • Report any healthcare fraud.

Healthcare fraud is a federal crime.  It is important to be aware of the signs and actions you can take to protect your patients and yourself.  According to the National Health Care Anti-Fraud Association they estimate billions of dollars each year are lost due to healthcare fraud.  Click here to check out the source and for additional information on healthcare fraud:

https://www.nhcaa.org/resources/health-care-anti-fraud-resources/the-challenge-of-health-care-fraud.aspx



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