Health care fraud is a crime. It is nothing but false information provided to the patients, and it involves providing false medical reports. Healthcare fraud is widespread and at its peak stage because the fraudsters are playing filthy games with people’s health. The patients won’t even suspect anything fishy as they rely on health care providers. By taking this as an advantage, fraudsters deceive many people.

Types of health care frauds

Healthcare frauds are divided into two categories they are:

Health care specialist fraud:

Physicians and other health care providers may commit fraud in some ways. It includes.

• Prescribing unnecessary medicines and selling them on the black market.
• Claiming a single bill multiple times.
• Claiming bills for the services they didn’t provide.
• Providing incorrect details.
• Wrong billing that is not covered under service.
• Adding unwanted diagnosis or treatment to increase the claim.

Health care customer fraud:

Customers can also commit health care fraud by

• Filing a claim by using others’ insurance cards.
• Claiming transport charges which are not used by the patients and used by others.
• Providing wrong information when applying for health insurance or other services.

Examples of Health care frauds:

Scammers are deceiving patient’s ‌by using health care fraud schemes. There are several types of health care scams that exist. Some of them are:

Billing for the unfulfilled services: This is commonly happening everywhere. Scammers charge for Medical aid from the patients, and they don’t deliver the item or thing to them. Since they maintain a false record to tally the records, they also bill for the services which are uncovered as a covered service. Patients generally have their health in mind rather than money since they are least expecting a fraud at this moment. So by taking this as an encouragement, scammers are doing health care scams.

Distorting dates of services: Health care providers charge more money from the patients by providing erroneous data about extra services and claiming to have visited the patient twice a day rather than once. So make sure to crosscheck the patient claim forms or doctor’s prescription with their service date.

Distorting the location of service: It happens commonly when the healthcare provider is on a trip or a vacation, but they maintain a false record to charge money from patients to whom they have provided service. But when we cross-check the patient’s claim form and service provided register, the dates may be mismatched or the location may be incorrectly stated.

Upcoding: Upcoding means billing for the services at higher charges rather than the actual service charges. Sometimes it may be a mistake but entering incorrect codes at the time of billing may lead to fraudulent practice.

Unbundling: Unbundling is like upcoding to maximize the reimbursement for a test. It will happen when a provider makes bills separately instead of billing together. It creates a higher cost.

Preventive measures on health care fraud:

There are many things to consider if you want to avoid being a victim of healthcare fraud.

Every patient has to look over their health care history. They should be aware of what tests they have conducted recently, and why maintaining proper records on bills is very important. If they fall for inaccurate diagnoses, it will lead to improper treatment.

Everyone has to educate themselves and be aware of what tests are done and required for their treatment.

Kickbacks: Kickbacks are the rewards medical professionals provide by rendering their services to the patients, like jewelry, free vacation trips, and so forth. These are common in health care fraud cases.

Review the bills and Statements: Patients must review all their accounts for accuracy.

Suppose you find any extra charges, you should consult your provider or a medical expert. You should also look for additional costs added to your bills without any acquired services or check for double billing. If you suspect any fraud, you can immediately report it to Health care fraud recovery firms for assistance.

Know your coverages: Make sure to know all the benefits of your insurance policy with explanations. Know what benefits are covered and also which insurance is covered.

Protect your cards:

• Handle your healthcare cards safely because healthcare identity theft is uncontrollable.

• Don’t share your cards with anyone except your doctor or medicare provider.

• Protect your health care cards like your credit cards.

Don’t accept free offers: Don’t entertain free offers and be suspicious about them because you have to know that any medical professional will not call you or visit your home to offer anything. Furthermore, if any healthcare services are provided for free, they could be potential schemes. Scammers may bill on your insurance despite declaring that their services are free of cost, if you accept it.

Conclusion:

Although we cannot control the health care frauds that are increasing in society. But we can take steps to avoid these frauds on an individual level. It impacts taxpayers financially, and people lose hope in medicare and healthcare systems. In addition, it is vital to educate yourself about health care providers to prevent fraudulent practices.