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Cybersecurity 5 min read2025-03-28

10 Warning Signs of Medical Fraud

Veracity Technologies Team
By Veracity Technologies Team 2025-03-28

Ten clear warning signs of medical fraud, plus practical steps you can take right now to protect yourself and your records.

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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

  1. Receiving bills or Explanation of Benefits statements for services you never received.
  2. Unfamiliar providers or facilities appearing on your insurance statements.
  3. Being denied coverage for a legitimate claim because your benefits appear "already used."
  4. Collection notices for medical debt you don't recognize.
  5. Errors in your medical records reflecting conditions or treatments that aren't yours.
  6. Unexpected calls or texts requesting your insurance information "to verify coverage."
  7. Notification from your insurer about a data breach involving your account.
  8. New insurance cards arriving that you didn't request.
  9. Prescription notifications for medications you were never prescribed.
  10. 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

  1. Request a copy of your medical records and review them for inaccuracies.
  2. Contact your insurer immediately to report suspicious claims.
  3. File a report with the Federal Trade Commission and consider a credit freeze if identity theft is suspected.
  4. 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.

Ready to strengthen your security posture?

Schedule a free technology and cyber risk audit with our team.

Published 2025-03-28 · Last reviewed December 2025