Insurance fraud is when an insurance plan holder or care provider deliberately falsifies, withholds, or modifies information or processes in order to claim benefits under an insurance benefits plan. Insurance fraud can happen at many stages of the care process and can be committed by an insurance plan holder, a care provider, or both.
Insurance fraud is illegal and can diminish your services over time.
Insurance fraud can take many different forms. Here are a few examples:
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Falsifying a claim. For example, creating a fake receipt with services that did not take place in order to claim the insurance benefits.
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Modifying details on a receipt in order to get a larger reimbursement than required. For example, a 30 minute session costing $50 took place, but the receipt is forged to show that a 60 minute session costing $100 took place, thereby eliciting $50 in fraudulent reimbursement.
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Claiming benefits under another person’s name. For example, if an individual has used up the benefits in their own plan, so they claim a therapy appointment under their partner’s name.
It is important to have a thorough knowledge of your insurance benefits plan, so that you can plan your services accordingly. Here are some tips to help avoid insurance fraud:
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Record any services you purchase with receipts, notes, or email and messaging correspondence.
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Only claim benefits under your own name, even if you are registered as a dependent on another person’s insurance plan.
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Ask questions of your care provider to ensure you have the correct information for your reimbursement purposes.
If you are unsure if something constitutes insurance fraud, need advice on what to do if you suspect insurance fraud, or want more information about insurance fraud, please reach out to our customer support by email (support@inkblottherapy.com) or live chat.