Fraud Awareness: Help Keep Medical Costs Down

What Is Healthcare Fraud, and What Are the Effects?

Healthcare fraud is the intentional misrepresentation of false information to obtain undeserved payment from a health insurance carrier. Healthcare fraud continues to rise and hurts everyone.

Here are the most current fraud trends and how they may affect you:

• Someone may use your Social Security number to acquire health insurance or medical services. This could interfere with future treatment and your credit standing.
• People acquire nonmedically necessary narcotic pain relievers for abuse or illegal sale. Narcotic substances used without following the specific instruction of a medical professional could cause serious harm or death.
• Falsified medical records or claims submitted under your name could interfere with future medical diagnosis and treatments. This can occur when someone steals or purchases physician or patient identification information and submits a falsified claim.
• A noneligible individual (such as your girlfriend, boyfriend, aunt, uncle, niece, nephew, etc.) added to your health insurance policy may cause you to become financially responsible for claim payments made on behalf of that person.
• Providing incorrect information or omitting details regarding prior or current medical conditions on an application for health insurance may interfere with eligibility.

How Can the Special Investigative Unit (SIU) Help YOU?

The Dean Health Plan SIU publishes the brochure Fraud Awareness: Helping to Control Healthcare Costs. See www.deancare.com for more information.

To discuss or report fraud and abuse or to request a copy of our brochure, contact:

Christina Sperry, AHFI, HIA SIU Investigator and Educator
Special Investigative Unit
christina.sperry@deancare.com
SIUDHP@deancare.com
608-827-4028

Dean Health Plan
Special Investigative Unit
1277 Deming Way
Madison, WI 53717

All information can be kept confidential.

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