Do you know what the most common workers’ comp fraud schemes are? According to the National Insurance Crime Bureau, fraud can cost insurers and employers over $7 billion a year. Studies show 10 percent or more of all property/casualty insurance claims are fraudulent. So what are the most common?

Fraudulent billing and billing codes, where the provider may bill for visits or services that never happened or bill separately for the workers’ comp insurer and the patient’s health insurance.

Unnecessary treatments, where the provider does provide services, but they are not related to the claim.

Illegal kickbacks, where providers may receive payments in exchange for a referral.

Soliciting, to steer injured workers to a certain medical provider.

Pharmaceuticals and equipment, where pharmacies bill for brand-name prescriptions while the patient receives generic or billing for medical equipment that was never utilized.

Medical fraud can come from single providers but also as part of organized crime rings that conduct multimillion-dollar schemes. Data and new technologies help carriers identify these schemes and keep an eye out for potential fraud in the future.

Read more here.