Healthcare insurance fraud is a serious issue affecting many patients and insurance providers, causing billions of dollars in yearly losses. It takes many forms, ranging from false claims to identity theft. It can cause patients to pay higher insurance premiums, deny them coverage, and put their personal and financial information at risk. To avoid becoming a victim of healthcare insurance fraud, it is essential to understand what it is, what it looks like, and what you can do to protect yourself. This guide is derived after the three-day top healthcare events scheduled in Dubai & Las Vegas – Health 2.0 Conference – so you can dodge the fraud and save your money!

What Is A Healthcare Insurance Scam?

A healthcare insurance scam is the intentional act of providing false and/or misleading information to an insurance company to receive a benefit or payment to which one is not entitled. Many types of healthcare insurance fraud exist, including false claims, upcoding, and identity theft.

False Claims:

False claims are one of the most common forms of healthcare insurance scam, says an expert who attended the Winter Edition of Health 2.0 Conference. This type of fraud occurs when a healthcare provider or patient submits a claim to an insurance company for services or treatments that were not provided. This can be done to increase the payment received from the insurance company or to receive payment for services not covered under the patient's insurance policy.

Upcoding:

Upcoding is another type of healthcare insurance fraud involving billing for more expensive procedures or services. For example, a healthcare provider may bill for a more complex and expensive procedure than was performed or bill for services that were not necessary.

Identity Theft:

Health 2.0 Conference reviews identity theft as a type of healthcare insurance fraud that involves the unauthorized use of another person's personal and financial information to obtain insurance benefits. This type of fraud is committed by individuals who steal personal information from medical records or obtain personal information from stolen mail or other sources.

What Can Patients Do To Avoid Healthcare Insurance Fraud? Learn From The Experts

There are several things that patients can do to avoid healthcare insurance fraud and protect themselves from becoming victims of spam.

Check Your Billing Statements:

Regularly reviewing your billing statements can help you detect false claims or upcoding. If you notice incorrect charges or services that were not performed, contact your insurance company immediately.

Protect Your Personal Information:

Be wary about giving out personal information, such as your social security number or insurance policy number, to anyone who calls or emails you. If you receive a call or email that appears to be from your insurance company, hang up and call the company directly to verify the information and report it as a scam, as reckoned by Health 2.0 Conference's day 3 panelists.

Be Careful When Choosing Healthcare Providers:

Before choosing a healthcare provider, research the provider to ensure they have a good reputation and are not known for committing fraud. You can also check with your insurance company to see if they have any information about the provider.

Report Suspected Fraud:

If you suspect that you have been a victim of healthcare insurance fraud, or if you suspect that someone else is committing fraud, report it to your insurance company right away. You can also report it to the National Health Care Anti-Fraud Association (NHCAA), a non-profit organization dedicated to fighting healthcare fraud.

Conclusion

Healthcare insurance fraud is a serious issue affecting many patients and insurance providers, causing billions of dollars in yearly losses. To avoid becoming a victim of fraud, it is crucial to understand what it is, what it looks like, and what you can do to protect yourself. Regularly reviewing your billing statements, protecting your personal information, being careful when choosing healthcare providers, and reporting suspected fraud are all critical steps that you can take to avoid healthcare insurance spam and protect yourself and others from becoming a victim of fraud. 

There's one more way of getting updated to such anti-scam and anti-fraud trends to safeguard your healthcare insurance – attending a healthcare event like the Health 2.0 Conference at least once a year!