
10 Warning Signs of Medical Fraud

Ten clear warning signs of medical fraud, plus practical steps you can take right now to protect yourself and your records.
Medical fraud - including identity-based insurance fraud and fraudulent billing - is a growing problem that can affect anyone, including Minneapolis-St. Paul business owners and their employees. Knowing the warning signs helps catch it before it causes lasting financial or medical record damage.
10 Warning Signs of Medical Fraud
- Receiving bills or Explanation of Benefits statements for services you never received.
- Unfamiliar providers or facilities appearing on your insurance statements.
- Being denied coverage for a legitimate claim because your benefits appear "already used."
- Collection notices for medical debt you don't recognize.
- Errors in your medical records reflecting conditions or treatments that aren't yours.
- Unexpected calls or texts requesting your insurance information "to verify coverage."
- Notification from your insurer about a data breach involving your account.
- New insurance cards arriving that you didn't request.
- Prescription notifications for medications you were never prescribed.
- Difficulty obtaining new insurance coverage due to a flagged claims history you don't recognize.
Why Business Owners Should Care Beyond Personal Risk
If your business handles employee health information as part of benefits administration, you carry a responsibility to protect that data - and a breach involving employee health records can create significant liability under HIPAA-adjacent obligations.
What to Do If You Suspect Medical Fraud
- Request a copy of your medical records and review them for inaccuracies.
- Contact your insurer immediately to report suspicious claims.
- File a report with the Federal Trade Commission and consider a credit freeze if identity theft is suspected.
- If it involves your business's benefits data, treat it as a potential data security incident requiring investigation.
Veracity Technologies helps Minneapolis-St. Paul businesses secure the sensitive employee health and benefits data they manage, reducing the risk of becoming a source of medical fraud exposure.
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Schedule a free technology and cyber risk audit with our team.
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Published 2025-03-28 · Last reviewed December 2025