Benefits fraud occurs when providers, facilities, clinics, or individuals intentionally submit claims with inaccurate or misleading information about the services or treatments provided. The most common types of benefits fraud include:
- Billing for services not rendered
- Up-coding of goods or services
- Submitting false claims
- Excessive or unnecessary services
- Falsifying patient records
- Co-pay activities
It’s estimated that hundreds of millions of healthcare dollars are lost to fraud each year in North America. If you suspect benefits fraud, you can help by emailing us or filling in the form below.