Insurance Fraud Reporting

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    The structure of the services index and definitions of the terms contained herein were orginally published in A Taxonomy of Human Services: A Conceptual Framework with Standardized Terminology and Definitions for the Field by the Information and Refferal Federation of Los Angeles County, Inc., 3035 Tyler Ave, El Monte, CA 91731; Copyright (c) 1983, 1987, 1991. No part of there listing of human service terms and definitions may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electrical, mechanical, photocopying, recording or otherwise without the prior written permission of the Information and Referral Federation of Los Angeles County, Inc.

    Taxonomy Code: FN-1700.3350

    Programs that provide a hotline or other mechanisms that the public can use to report, usually anonymously, individuals who have made false statements or otherwise intentionally misrepresented the facts surrounding an injury or loss in order to receive or increase the amount of compensation they will receive based on an insurance policy. Also included are programs that accept reports of fraudulent claims submitted by health care providers, pharmacies, auto repair shops and other parties that are providing services for insured individuals and using their insurance as a means of payment.

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    Service NameDescriptionLocationProgramAgency
    Medicare Fraud Reporting - Denver Regional Council of Governments (DRCOG)Provides clients with Medicare a way to report suspected Medicare fraud through the Senior Medicare Patrol. Some potential situations that can be reported are: - Medicare billing errors - Charges from a hospital or supplier that were not received - Questions regarding Medicare Summary Notices - Suspected fraud Denver CountyDenver Regional Council of Governments (DRCOG)Denver Regional Council of Governments (DRCOG)
    Senior Medicare Patrol and Medicare Fraud - Senior Resource Development AgencyEmpowers seniors and others to address issues of Medicare fraud, billing errors, and program abuse. Recruits volunteers to educate community members on actions they can take to prevent, detect, and report fraud. Also provides one-on-one reviews of potential fraud or abuse complaints. Pueblo CountyADRC / 211 / Senior Link / SHIPSenior Resource Development Agency

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