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Watch a brief video on the False Claims Act to help you understand and comply with this law. False claims are not claims with innocent billing mistakes. Providers know these claims are false, and they include services that are:Who is responsible for blowing the whistle on false billing claims?
"Blowing the whistle on false billing claims used to inflate payouts, pad reimbursements, and falsify records - is a shared responsibility of all healthcare professionals..." Simply defined as Healthcare providers or clinics representing incorrectly, improperly or false records of services.What kind of fraud is no supporting documentation?
Known to Fraud Examiners as “no supporting documentation fraud”. This includes medical services, products, drugs or equipment. There are a variety fraud schemes commonly used.Why is insurance fraud a problem in California?
According to Section 1871 (h) of the California Insurance Code, health insurance fraud is a particular problem for health insurance policyholders. Healthcare fraud causes losses in premium dollars and increases healthcare costs unnecessarily.