Chiropractic care received for TMJ although no other chiropractic care is noted. Dental bills submitted which incorrectly show treatment in two different calendar years. This is to assure that coverage is not maximized in one year. Dental bills are padded or inflated to reimburse for co-payments or deductible. Dental bills submitted for services not rendered, such as billing for crown and bridge work where root canal was actually performed.
Medical provider submits identical claims for the same patient in different calendar years.
Several medical bills submitted on different dates, each showing same dates of service or overlapping dates of service. Dates of service in doctor's notes do not match dates of service on the bill. Office visits are not itemized by date and type of service. Medical bills list duplicate procedures or unbundled procedures to maximize payment. Medical services billed but not rendered.