Fact Based List:

10 Popular Health Care Provider Fraud Schemes

Submitted by Anonymous on Wed, 01/09/2013 - 17:17


  1. Billing for services not rendered.
  2. Billing for a non-covered service as a covered service.
  3. Misrepresenting dates of service.
  4. Misrepresenting locations of service.
  5. Misrepresenting provider of service
  6. Waiving of deductibles and/or co-payments.
  7. Incorrect reporting of diagnoses or procedures (includes unbundling).
  8. Overutilization of services.
  9. Corruption (kickbacks and bribery).
  10. False or unnecessary issuance of prescription drugs.


Source: The Association of Certified Fraud Examiners
Source URL: http://www.acfe.com/article.aspx?id=4294976280



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