Beware of These 5 Common Health Insurance Frauds

As healthcare costs continue to rise, having health insurance has never been more important. With the increasing demand for health insurance, comes an increased risk of fraud. In 2019, the Federal Trade Commission received over 150,000 reports of healthcare fraud, resulting in losses of $1.9 billion. In this article, we will discuss the top 5 common health insurance frauds to beware of.

1. Phantom Billing

Phantom billing is a type of fraud where providers bill for services that were never provided, or they bill for a more expensive service than what was actually performed. This type of fraud can also occur if a provider bills for a service that is not medically necessary. To protect yourself from phantom billing, always check your Explanation of Benefits (EOB) and make sure that you received the services that were billed for.

2. Unnecessary Procedures

Unnecessary procedures or treatments are often performed to inflate the billing amount. This can occur if a provider recommends a procedure that is not medically necessary or if they perform a procedure that is not needed. Always do your research and get a second opinion before undergoing any procedure or treatment.

3. Identity Theft

Identity theft is when someone uses your personal information to obtain healthcare services or prescriptions. Always keep your personal information secure and do not share it with anyone. If you suspect that your identity has been stolen, report it to the appropriate authorities immediately.

4. Insurance Brokers

Insurance brokers may try to sell you a plan that is not appropriate for your needs or may even enroll you in a plan without your consent. Always do your research and make sure that the insurance broker is reputable. Additionally, only enroll in a plan that meets your needs and budget.

5. Prescription Drug Fraud

Prescription drug fraud occurs when someone obtains prescription drugs through fraudulent means, such as using someone else’s prescription or falsely claiming to have a medical condition. Always keep your prescriptions secure and do not share them with anyone. If you suspect that your prescription has been tampered with or stolen, report it to your healthcare provider immediately.

In conclusion, healthcare fraud is a serious issue that can cost individuals and society billions of dollars each year. By being aware of the common health insurance frauds and taking the necessary precautions, you can protect yourself and your financial well-being. Remember to always verify that the services you receive are necessary and legitimate, only share your personal information with reputable sources, and be cautious of insurance brokers and prescription drug fraud.

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