What are common forms of health care fraud?

Billing for services not furnished and unbundling are recognized as common forms of health care fraud because they involve deliberate misrepresentation in order to gain financial benefits. When a healthcare provider bills for services that were never actually provided, they exploit the billing system for illicit financial gain. Unbundling, on the other hand, refers to the practice of separating a set of services that should be billed together, in order to receive a higher total payment from insurance carriers than if the services were billed as a single comprehensive procedure. Both practices are considered fraudulent as they violate ethical standards and legal regulations related to healthcare billing and insurance claims.

In contrast, providing unnecessary patient education might be an ethical concern but does not directly constitute fraud unless it leads to billing for non-existent services. Offering discounts for early payments is a legitimate business strategy and not fraudulent in nature. Similarly, administrative errors in insurance claims may happen unintentionally and typically do not involve the intent to commit fraud.