Direct answer
If you notice suspicious charges on your Explanation of Benefits, you should first contact your insurance company’s fraud department directly to dispute the claim. If the company fails to address the discrepancy, you should file a report with your state’s insurance fraud bureau or the National Health Care Anti-Fraud Association.
National Health Care Anti-Fraud Association standard reporting guidelines. For additional information about identifying and reporting health care fraud, see the U.S. Department of Justice‘s guidance on criminal enforcement.
What this means for you
If you notice suspicious charges on your Explanation of Benefits, you should first contact your insurance company’s fraud department directly to dispute the claim. If the company fails to address the discrepancy, you should file a report with your state’s insurance fraud bureau or the National Health Care Anti-Fraud Association.
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