Fraud quiz

This is an online quiz of 13 questions. Each question has one correct answer. Good luck!

Healthcare fraud is an intentional act of deception in order to receive healthcare benefits which, for whatever reason, would not ordinarily be covered.
Health plan members, physicians and agents are equally likely to commit healthcare fraud
Healthcare fraud accounts for up to $100 million in losses annually.
Intentionally giving false information on a claim is not fraud if a service, any service, was performed.
Changing the dollar amount on a bill or receipt prior to submitting for payment is an alteration, and constitutes fraud.
An accident purposely committed in order to receive benefits of any coverage is healthcare fraud.
A material misrepresentation occurs when an important fact is omitted from a document.
A person who intentionally sends a forged or altered document through the U.S. mail or fax machine has committed a crime.
What does the term "clean sheeting" mean?
An application for coverage purposely signed and dated to conceal an illness or injury in order to receive coverage can be considered a fraudulent application.
Placing an individual who is not qualified as a dependent on a health plan is not a fraud.
Generally, an individual who is not a legal employee or a dependent of an employee cannot be placed on an employer group plan.
An unrelated person cannot pay the health plan dues/premium on behalf of the covered person.

Answers:
1) True 2) True 3) False - The losses are in the billions, not millions. 4) False - Intentionally giving any false information for any reason is fraud. 5) True 6) True 7) False - It must be intentionally omitted to be considered fraud. 8) True 9) B - Clean sheeting means obtaining life insurance polices by hidng life threatening illnesses 10) True 11) False 12) True 13) False

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