What types of fraud are most commonly encountered in insurance claims?

One of the most common health insurance scams involves collecting personal information while trying to sell fake health insurance coverage. For example, the scammer may make an unsolicited call and tell a Medicare recipient of the new monthly fee required to continue coverage. As part of the call, the scammer says they need to verify the recipient’s social security number, bank account and/or credit card number. 
Another common scam is selling coverage that adds little value. For example, the scammer may sell a prescription drug plan that has so many restrictions that it is almost worthless to the buyer.

The Federal Bureau of Investigation (FBI) lists the following common types of health care fraud committed by medical providers:

- Double billing
- Phantom billing, which is billing for services not provided
- Unbundling, which is submitting multiple bills for the same service
- Upcoding is billing for a more expensive service than the patient actually received.