Help prevent healthcare fraud

When individuals visit multiple physicians or emergency rooms to obtain several prescriptions for controlled substances

Allowing an uninsured person to use another individual's insurance cards

The illegal use of another person's personal information to obtain medical services or prescription drugs

Keeping an ex-spouse, former dependent, or even non-family members on an health insurance policy

Billing for services or prescriptions that were never provided or dispensed

Billing separately for procedures and supplies that should be grouped under a single procedure or global fee

When a provider submits a claim for a more expensive service, supply or piece of equipment than what was actually provided

Involves providers not directly engaged in patient care using telemarketers to promote high-cost medical products or services

Billing procedures under different names or using alternative Current Procedural Terminology (CPT) codes to obtain coverage for services not typically covered—such as cosmetic or experimental treatments

When providers exchange money or things of value for the referral of patients for services that are not medically necessary or have no validity or diagnostic value, as well as waiving copays and/or deductibles

When DME companies use multiple provider numbers or business names to bill for both the rental and purchase of the same equipment. They might also bill for equipment or supplies never received by the patient.