In California, the complexity of medical billing and payments can lead to healthcare insurance fraud. Healthcare fraud can be committed by both patients and doctors. Common types of fraud include billing patients for a service never received, submitting fraudulent claims, billing for a more expensive service that a patient never received, submitting duplicate billing claims, and preparing false documents to support a fraudulent claim. Many healthcare insurance fraud cases are related to the California government programs like Medi-Cal which may leave low-income patients and elderly patients at risk for insurance fraud. Healthcare Insurance Fraud in California can also be referred to as insurance fraud, medical billing fraud, Medicare fraud, or Medi-Cal fraud. 

Fraud by Healthcare Provider  

Fraud by medical and legal professionals, including doctors, psychologists, laboratory companies, pharmacists, and others, may bill insurance companies for services not provided to patients. Additionally, professionals may prescribe unnecessary procedures, medical supplies, or medications.  

Tips to Avoid Healthcare Fraud: 

1. Treat your Health Insurance information like a credit card! 

2. Don’t provide your health insurance information to a “free” service. 

3. Check your Explanation of Benefits frequently