Report Fraud and Abuse
HAP's Compliance Hotline
What is health care fraud?
Health care fraud is any act of falsifying health care transactions for financial gain or other benefit. It can be done by a doctor, a business or a member of a health plan. Anyone convicted of this serious crime may face time in prison and major fines. If you ever suspect fraud, please report it right away.
How does health care fraud affect you?
While only a small percentage of people commit health care fraud, the costs to Americans averages about $80 billion a year. Fraud increases total health care costs, which means you may have to pay more for benefits.
Types of health care fraud
There are many types of fraud related to health care. Here are some of them:
- Billing for health care services that did not happen
- Health services done simply to get reimbursement
- Filing claims for health services or drugs not received
- Forging or altering bills, receipts or other health care forms
- Doctor shopping to get multiple prescriptions
What is HAP doing to stop fraud?
HAP uses special software that continuously looks at claims data and other information that identifies claims that need to be investigated. HAP employs a team of highly skilled professionals who are dedicated to looking for and identifying instances of health care fraud. All of these measures are designed to protect HAP's members.