Health care practitioners also a target of health claim fraud: FSCO

Insurers aren’t the only targets in fraudulent health care claims, health care practitioners are also being targeted, warned the Financial Services Commission of Ontario (FSCO) in a bulletin.
FSCO describes a common scenario in which clinic owners/operators and others in the system misuse the signatures and credentials of health care practitioners.
“They steal a heal care practitioner’s name and College registration number and forge signatures,” the bulletin says. “They use this to falsify client records of treatment and assessment plans that were never provided and insurance payments are then forwarded to a phony address.”
FSCO says this can also happen when health care practitioners leave a practice and the clinic fraudulently uses their signatures and information after they leave.
Warning signs of fraudulent activity include:
•Suspicious documents: treatment and assessment plans, invoices or other records that look altered or forged, or that do not match documents on file.
•Suspicious activities: a client complains about receiving a bill for a service he or she never received, or a client reports an inconsistency between a treatment and assessment plan and his/her own records.
FSCO offers a series of steps health care practitioners can take to protect themselves. These steps included:
•Inform the regulatory college where you are registered when you move from one clinic or facility to another.
•Never sign blank treatment and assessment plans.
•Explain the treatment and assessment plan to your client. Make sure your client signs treatment plans only if he or she understands the goods and services being proposed and the costs and the goals of treatment.
The full bulletin can be found at: www.fsco.gov.on.ca/en/auto/brochures/Pages/auto-reducing-abuse.aspx