Health Care Fraud

What is Health Care Fraud?

Health care fraud is when a dishonest person purposely submits or makes someone else submit, wrong or misleading information to CHNCT so they can get health benefits or money. This is a crime. There are many types of health care fraud. Here are some of the more common examples:

• Billing for patients who did not get any services
• Billing for old items as if they were new
• Billing for more hours than there are in a day
• Billing for tests that a patient did not need
• Overcharging for health care services that were provided
• Offering someone money or something of value in exchange for a referral for medical services

How You Can Help?

These are things you can do to help fight against fraud and abuse:

• Never let somebody else use your CHNCT Member Identification Card. Always keep your ID card in a safe place.
• If your doctor offers you free services, ask why and let us know about it.
• If anyone tells you they know how to make CHNCT pay for health care services that CHNCT usually does not pay for, you should stay away from them and let us know about it.
• Understand the type of treatment you are getting- ask your doctor about it.
• Do not ask your doctor or other health care provider for medical care that you do not need.
• If you think someone may have committed fraud, call CHNCT?s toll-free Fraud Reporting Hotline at 1-866-700-6109 and tell us about it