Health care fraud is the deliberate submission of false information to gain undeserved payment on a claim.
Abuse involves a questionable practice inconsistent with accepted medical or business policies. While not an intentional misrepresentation, it may result in unnecessary costs.
Items or services on your Explanation of Benefits (EOB) which:
Fraudulent and abusive claims can affect your health care history. If a claim is filed for a service you didn't receive, this could: