Double billing: Submitting multiple claims for the same service, showcasing common fraud types.
Phantom billing: Billing for a service visit or supplies the patient never received is a notorious fraud type.
Unbundling: Submitting multiple bills for the same service is a frequent type of fraud.
Upcoding: Billing for a more expensive service than the patient actually received.
Fraud Committed by Patients and Other Individuals
Bogus marketing: Convincing people to provide their health insurance identification number and other personal information to bill for non-rendered services, steal their identity, or enroll them in a fake benefit plan involves a serious fraud type.
Identity theft/identity swapping: Using another person’s health insurance or allowing another person to use your insurance.
Impersonating a health care professional: Providing or billing for health services or equipment without a license demonstrates common fraud types in health care.
Fraud Involving Prescriptions
Forgery: Creating or using forged prescriptions is one of the fraud types affecting prescriptions.
Diversion: Diverting legal prescriptions for illegal uses, such as selling your prescription medication.
Doctor shopping: Visiting multiple providers to get prescriptions for controlled substances or getting prescriptions from medical offices that engage in unethical practices demonstrates a dangerous fraud type.
