Health Insurance Claims fraud

Health & Insurance----Fraud can be committed by anyone without exception - especially in the field of insurance. Fraud can be committed by policyholders, a health care provider or even employees.

This is usually done by destroying, hiding or deceiving through the information on insurance claims, making it profitable for a person or entity. This is then referred to as health insurance claims fraud.

1. Fraud by the policyholder

Fraud committed by policyholders could be composed of members who do not qualify, concealment of disease, age concealment, failure to report important information, giving false information about yourself or other family members, failure to disclose previous claims settled or rejected, in prescription fraud doctor, false documents, false claims, exaggerated claims and many other things you can do to pull through fraud by the policyholder.

2. Fraud by health care providers or employees

Fraud by Providers of Health or its employees, including the preparation of false claims by bogus doctors, the bill for products or services not provided, the filing excessive claims, billing is prepared for a higher level of service, modifications or changes made in the filing of claims, changes in the diagnosis of the patient documentation , fake, and fraud committed by hospital staff or health care provider of products / services in order to make a quick buck.

False and dishonest claims are very damaging for the insurance industry, which could cause loss of not a few. Intent to deceive, to benefit from the insurance industry, claims preparation or excessive or increased medical bills and malafide intention to encourage companies to pay more than necessary, devise innovative methods and tactics, including tactics of pressure, favoritism, nepotism and other forms of fraud that is growing by leaps and bounds since the last decade.

Because so many cases of fraud were then given severe punishment for those who do so. Therefore be careful, honest and do not try to cheat.