Health care fraud occurs when you submit false or misleading information to your health care insurance company for the purposes of receiving benefits and/or reimbursements. Whether you are a doctor or a patient, If you commit health care fraud, you may face imprisonment or be fined heavily. Who Might Commit Health Care Fraud?Health care fraud can be committed by dishonest health care providers (doctors, dentists, or lab technicians) or by the health care plan holders themselves.
Examples of Fraud By a Health Care Provider:- giving a false diagnosis to justify tests/procedures that are unnecessary;
- billing for medical procedures that were not really performed or that were not really needed;
- waiving member co-pays and over-billing the insurance provider instead;
- misrepresenting non-covered procedures (like cosmetic surgery) as covered ones
Example of Fraud By a Health Care Member:- altering health care bills or forging them to get health care reimbursements;
- filing claims for medical procedures and/or prescription medication that you did not receive;
- using someone else's insurance card or allowing someone else to use yours
Should I Consult an Attorney If I am Accused of Health Care Fraud?If you are accused of health care fraud, you should contact an attorney immediately. A criminal defense attorney can explain your rights and help defend you in court if needed. |
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