Medical Services Fraud If you are injured in a vehicle collision, medical services help you recover. However, unscrupulous rehabilitation clinics and assessment centres may engage in fraudulent activities. There are a number of ways fraudulent activities may take place when it comes to medical services fraud. Some examples may include: Overbill for services performed or bill for services that are not performedProvide and bill for additional, unnecessary assessments, treatments, examinations or assistive devicesProvide and bill for an uncovered service as though it is a covered serviceBill for assistive devices that are never provided Abuse or falsely use credentials of health practitioners to authorize billing frauds.Who is Involved with Falsified Documentation?During or after a patient receives legitimate medical care, falsified documents may be submitted by dishonest medical service providers. A patient who signs a blank form or whose signature is physically or electronically forged may not be aware of the fraud. Similarly, a health care practitioner who does not know his or her credentials are being fraudulently used may be unaware of false or exaggerated billings. In some cases, a complicit patient and/or health care practitioner takes part in false or exaggerated billings. A patient who never sustained injuries in a legitimate (staged or caused collision may make a false injury claim. How Patients Can Avoid Medical Services Fraud After an injury, protect yourself and ask to see the credentials of the practitioner who provides your medical services. You may consider checking the public registry of the practitioner’s affiliated college to confirm his or her professional status. Never sign blank medical insurance forms and never sign any documentation without being fully aware of the content.Professional Identity Theft ScenariosThe false use of a health care practitioner’s name and professional credentials is a serious problem and can happen in several ways:A practitioner may work at a facility and submit valid treatment and assessment plans to insurance companies. An unscrupulous facility may submit additional requests for unnecessary treatment and assessments under a practitioner’s name without the knowledge or consent of the practitioner.A practitioner may have once worked at a facility that continues to submit requests for treatments or assessments and/or invoices under that practitioner’s name after the practitioner leaves.A practitioner may have never worked at a facility. The practitioner’s professional credentials are obtained without her or his knowledge and are fraudulently used by the facility to authorize insurance forms. How Practitioners Can Avoid Identity Theft Know what requests for treatment or assessments and invoices are submitted to insurers under your name. Maintain independent access to all patient records and/or keep an independent file for all patient documentation. Additional ResourcesCanadian Life and Health AssociationOntario only: Health Claims for Auto Insurance (HCAI)HCAI Professional Credential Tracker Take the Time. Report the CrimeInsurance crime isn’t always the work of organized groups or gangs running auto theft or insurance crime rings as a business. It can also involve normally law-abiding citizens who attempt to make a few extra dollars by padding an otherwise legitimate claim.So, You've Had an AccidentAccidents are stressful, but stay calm, and use this form to record important details. Filing an Insurance ClaimSometimes life happens. If you’ve been in a collision or if your home has been burglarized or damaged in some way, you’ll want to get your life back to normal as quickly as possible. Consider these tips when filing an insurance claim to help make the process a little easier Related ServicesStaged CollisionsA staged or alleged vehicle collision supports false auto insurance claims. Staged collisions put innocent drivers at risk and contribute to higher insurance premiums. Auto Repair Facility FraudInflated towing fees and repairs to damages that existed before the insured incident are elements of auto repair facility fraud. Be mindful of repair facilities that take part in fraud. Employment FraudBusinesses can be greatly impacted by employment fraud. Recognize the insurance fraud situations that may occur and count as insurance fraud. Paper Fraud and Jump-InsWhen a criminal reports a collision that never occurred, it’s known as paper fraud. Jump-ins are reported as collision occupants but were not in the vehicle at the time of the reported collision. Useful LinksInsurance FraudInsurance fraud is serious business and costs us all. Think the fender bender you saw might not have been so accidental? Canadian National Insurance Crime Services (CANATICS)CANATICS uses technology to support the fight against auto insurance fraud in Canada. We do this with an unwavering focus on privacy and security.