Things You Should Know About Health Insurance Scams

Fraud in the health insurance industry is not as uncommon as one might have thought. Because of this, it would be very wise of you to be aware of what to look out for so that you can protect yourself from any type of scam. Health care providers like attorneys, diagnostic labs, nursing homes, hospitals and doctors may all try to defraud the consumers.



How Do Service Providers Do It?

There are several different ways in which service providers may defraud health insurance consumers, as listed below:

  • Billing the insurance companies for costly equipment, tests or treatments that the patient may have never received or had.

  • Double triple billing the insurers for the same treatment

  • Sell insurance covers of low cost from fake companies

  • Providing insured individuals life threatening, dangerous or unnecessary treatments

  • Stealing information and using it to bill the insurance companies for false treatments

As an insured party, you may become a victim of such scams which can leave you with damaged credit ratings, medical debt and false health records.


Things To Look Out For

Given below are a few things to look out for when you search for health insurance providers:

  • Providers that may bill your insurance company for the services that you never used

  • Prescriptions for any type of controlled substances with no medical reason

  • Misrepresentation health care or cosmetic procedures that are not covered by the insurance plans

  • Billing insurance company for any branded drugs when you actually only got generic drugs.

When you notice any type of medical service provider doing any of the above mentioned things, it is necessary for you to keep all the paperwork handy to use later as a reference and also inform your insurance company immediately.


Protect Yourself

There are a number of things that you can do in order to protect yourself from fraud. Only get insurance from a licensed insurance company. Also check for any type of fraud convictions, consumer complaints against the insurance company that you select. It is also wise to always maintain a detailed record of your medical bills and procedures and review all your bills and statements. Do not sign insurance claim forms if they are blank and avoid salespersons that offer you free advice or health services. Keep your medical information and records protected and know what your insurance policy covers. It is also wise to never pay any of your premiums for insurance in cash and maintain the premium receipts. All of these steps will protect you against health insurance scams in the future.

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