Fraud Information

Help NHC stop Healthcare Fraud, Waste, & Abuse!

Fraud is an intentional deception or misrepresentation for the purpose of defrauding NHC of money or property.

Examples:

  • Billing for a service not furnished
  • Billing for services at a higher rate than is actually justified
  • Deliberately misrepresenting services, resulting in unnecessary cost, improper payments or overpayment

Waste is the unintentional misuse of resources or reporting of services provided which result in unnecessary cost to healthcare industry.

Examples:

  • Duplicate Billing
  • Unbundling of Procedure Codes
  • Charges in excess for services or supplies
  • Providing medically unnecessary services
  • Providing services that do not meet professionally recognized standards

Abuse is the unintentional providing of information that results in payment for items and services which were not medically necessary or legally required.

Examples:

  • Upcoding of procedures
  • Bill-splitting
  • Over-utilization of services
  • Misuse of resources

To anonymously report suspected fraud, waste or abuse, call 844-879-7025.