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THE FRAUD MATRIX

Healthcare & Benefits Fraud

Schemes where providers or others misuse your insurance, Medicare, or Medicaid coverage — billing for services you never received, offering cash for your benefits number, or recruiting you into staged claims.

  1. Recruit

    Providers or 'marketers' offer perks for your insurance or benefits number.

  2. Bill

    Services, tests, or equipment are billed under your coverage without care.

  3. Inflate

    Claims are padded or staged accidents generate extra billings.

  4. Payout

    Fraudulent reimbursements flow to clinics and recruiters.

  5. EOB

    An Explanation of Benefits you can't explain surfaces the scheme.

Question 1 of 6
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Healthcare & Benefits Fraud

Were you asked to lend your insurance or Medicare card number so someone else's treatment or equipment could be billed under your coverage?