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  • Home
  • Types of Fraud
    • Healthcare Fraud
    • Respiratory Fraud
    • Podiatry Fraud
    • Financial ​Fraud
    • FCPA Fraud
    • Managed Care Insurance Fraud
    • Nursing Home Fraud
    • Pharmaceutical Fraud
    • Procurement Fraud
    • Sponsored Genetic Testing Fraud
  • Laws & Programs
    • FCA
    • CDI
    • SEC
    • CFTC​
    • FCPA
  • About Us
  • Whistleblower Education
  • Contact
Report fraud
Medical Bill Codes And Spreadsheet Data.

High-Profile Medical Billing Fraud Cases: A Case Study

July 6, 2023 No Comments

Medical billing fraud continues to be a pervasive issue in the healthcare industry, causing significant financial losses and undermining the integrity of patient care. Healthcare

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Understanding Risk Adjustment Factor (RAF) Score Fraud and How to Get a Reward for Reporting It

June 15, 2023 No Comments

Managed Care Medicare and Medicaid fraud have become pervasive in the United States, costing taxpayers billions of dollars annually. One form of healthcare fraud that

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File a Whistleblower Claim in Exposing Healthcare Fraud

The Benefits of Being the First to File a Whistleblower Claim in Exposing Healthcare Fraud

June 1, 2023 No Comments

Whistleblowing to expose healthcare fraud is a courageous act that reveals unlawful practices and protects patients from substandard care. However, to be effective, whistleblowers must

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Common Medicare and Medicaid Scams

Top 7 Most Common Medicare/Medicaid Scams by Medical Providers

May 3, 2023 No Comments

Medicare is a federal health insurance program that covers eligible individuals who are over 65 years old, disabled, or have end-stage health complications. State or

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Billing and Coding Fraud in Managed Care Organizations

Billing and Upcoding: How Physicians Can Stand Up to Managed Care Organizations

April 28, 2023 No Comments

As healthcare costs continue to rise, government programs such as Medicare and Medicaid, as well as private insurers, rely heavily on managed care organizations (MCOs)

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How to Report Fraud in Long Term Care Facilities

Typical Types of Fraud in Long Term Care Facilities and How to Report Them and Potentially Earn a Reward

April 11, 2023 No Comments

Fraud within Long-Term Care and Assisted Living Facilities is a serious issue. It’s important to be aware of the various forms of fraud that can

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Healthcare Fraud and the Impact on Vulnerable Populations

How Healthcare Fraud Impacts Vulnerable Populations

February 20, 2023 No Comments

It’s easy to see how healthcare fraud can cost taxpayers and governments billions of dollars every year. And while that is not something to be

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Top Managed Care Fraud Trends

Top Managed Care Fraud Trends to Look For in 2023

February 6, 2023 No Comments

According to the National Library of Medicine, managed care refers to a healthcare insurance approach that integrates the financing of care and related services to

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Report Medical Loss Ratio Fraud

What Does Medical Loss Ratio Fraud Look Like in Managed Care

January 23, 2023 No Comments

Medical Loss Ratio (MLR) fraud occurs when plans knowingly misrepresent a proportion of funds spent on patient care and quality improvement measures as opposed to

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Expose Medicare Advantage Fraud

Managed Care: Exposing Medicare Advantage Fraud and Abuse

January 11, 2023 No Comments

Medicare Advantage is a type of health insurance plan offered by private companies contracted by the government. Also known as Medicare Part C, Medicare Advantage

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Top Eight Things to Know Before Whistleblowing

January 11, 2024 No Comments

The healthcare industry is one that thrives on trust and ethics. When that trust is compromised by fraudulent activities, it’s essential to take a stand.

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The Catalyst Link: How Whistleblowers Initiate the Chain of Force to Shed Light on Fraud

December 23, 2023 No Comments

In this blog, we will explore the journey of whistleblowers, those who discover and report healthcare fraud, and how they are the catalysts that set

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Unlocking Whistleblower Rewards: Strategies for Maximizing Your Compensation

December 12, 2023 No Comments

Whistleblowers play a crucial role in exposing unethical practices, fraud, and other wrongdoings in various sectors. Recognizing their importance, many jurisdictions offer financial rewards to

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Breaking the Silence Shining a Spotlight on Sponsored Testing Programs

Breaking the Silence: Shining a Spotlight on Sponsored Testing Programs

September 25, 2023 No Comments

The healthcare industry has witnessed a growing collaboration between pharma companies and genetic testing firms in what is known as sponsored testing programs. Under the

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Doctor giving a consultation to a patient and explaining medical information and diagnosis.

Top 10 Most Common Types of Medical Fraud and Their Legal Consequences

September 25, 2023 No Comments

Medical fraud is a pervasive issue that undermines the integrity of the healthcare system, affecting patients, providers, and taxpayers alike. As healthcare costs continue to

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Healthcare, help and physical therapy with patient and woman in nursing home.

How to Spot the Red Flags of Physical, Occupational and Speech Therapy Fraud

September 13, 2023 No Comments

Medical billing fraud is a rampant problem that affects all areas of the healthcare industry. Unfortunately, rehabilitation (rehab) therapy fraud is on the rise, posing

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Side view of diverse medical team of doctors discussing their shifts on chart at hospital.

Unveiling the Unfortunate Reality: How Doctors Become Unwilling Participants in Medical Billing Fraud

August 29, 2023 No Comments

Medical doctors should be able to focus on providing the best possible care for their patients. However, in the complex world of healthcare, it’s not

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Medical Coding Bill And Billing Codes Spreadsheets

Will AI replace medical billing and coding and what impact would that have on billing fraud?

August 15, 2023 No Comments

In the ever-evolving landscape of healthcare, advancements in technology continue to shape the industry. One area that has garnered attention is artificial intelligence (AI) and

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Whistleblower defined on a piece of paper.

National Whistleblower Appreciation Day: Recognizing the Courage and Challenges of Bringing Fraud to Light

July 30, 2023 No Comments

In a world where accountability and transparency are paramount, whistleblowing serves as a powerful tool to combat fraud. Whistleblowers play a crucial role in exposing

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