Dental insurance fraud occurs when someone steals valid coverage to either obtain services or receive compensation from an insurance company. An individual can commit fraud independently (e.g., by letting a friend use your dental insurance) or participate in an organized scheme (e.g., charging insurance company more than should be billed). In all states, intentional insurance fraud represents a criminal violation. Federal criminal violations can arise depending on the extent of the fraud.
Gather relevant information to support your suspicions. You could disclose the name and addresses of the scam artists. When dealing with a dentist who overcharges for services or do not report patient co-payments, you could provide direct contact information, such as the dentist's office location and phone number.
Contact the fraud department of your state's fraud or insurance department (e.g., insurancefraud.org/fraud_bureaus.htm). For example, if you are a consumer in Delaware, contact the Department of Insurance and file a complaint by email at email@example.com or by telephone 1-800-282-8611.
Notify the insurance company directly. If the dental insurance is through Blue Cross Blue Shield, call the anti-fraud hot line at 1-800-482-378. Medicaid maintains an Office of Medicaid Inspector General in each state to gather information about fraudulent activity. You can make anonymous report of Medicaid fraud in New York at (877) 873-7283.
File a complaint with the Better Business Bureau (bbb.org/us/consumers) that describes the fraud. The BBB collects and publishes information about businesses and nonprofits throughout the United States. In 2008, the BBB received over 272,000 inquiries about dentists.
Tips & Warnings
- If you do not want to identify yourself, report dental insurance fraud anonymously without disclosing your name and contact information.
- Do not make a false report, (e.g., because you are angry with a person), because an investigation generally will develop based on the information submitted. Filing a false report is a crime and carries consequences.
How to Report Health Insurance Fraud
Health insurance fraud occurs when a person submits or leads another person to submit fake or incorrect information to increase the amount...
How to Sue a Health Insurance Company
Litigation is often the result of the failure of two parties to reach a mutually acceptable agreement. Insurance companies are the subject...
How to Report a Bad Dentist
According to the United Press International website, more than 80 percent of people are afraid of going to the dentist. They come...
How to Report Insurance Fraud in California
Insurance fraud hurts everyone who buys an insurance policy since insurance premiums are based on the number and size of claims made...
How to Report Insurance Fraud in Pennsylvania
There are a lot of different behaviors that constitute insurance fraud. For instance, if a person purposefully provides false or misleading information...