What To Do If You Spot A Fake Bill? The Ultimate Guide

Spotting a fake bill might seem difficult in today’s world, but it is rampant. That’s why many people are asking what to do if you spot a fake bill in the healthcare industry.

According to medical billing specialists, the United States government loses 30 cents on every dollar received due to fraudulent activities and medical billing schemes.

Fake bills in medical billing will be regarded as one of the forms of healthcare fraud in the country. It would therefore be noted that healthcare fraud would cost the United States anywhere from 3% to 10% of the country’s healthcare spending, according to a 2024 report.

This is to show that fake bills in medical billing could be as impactful on the government as they are on you. So you are not alone.

However, medical office software can significantly help you get most of the things you are required to put in place, avoiding fake bills, including keeping track of your medical bills effectively and efficiently.

However, with the rising healthcare costs, it is wise for everyone to review their medical bills carefully. It is vital to ensure that every cent of your hard earned money that goes toward your healthcare payment is correct.

Minor unintentional typos here and there should not be a cause for concern. Medical administrative employees can make mistakes, and these occurrences are more common than you might imagine.

In this article, we will cover all you need to know about fake bills in medical billing, including pro advice for avoiding them, what to avoid, and basic actions to maintain accuracy and prevent medical billing fraud, so without further ado, let’s get started!

What Is A Fake Bill In Medical Billing?

A fake bill in medical billing is a bill for a treatment you didn’t receive. On the other hand, a “fake bill” in medical billing is a bill that merchants or third-party providers generate to look to be a legitimate medical bill to defraud the victim.

Fake bills in medical billing have caused more harm than good over the years, and people won’t sit back to watch any longer. Researchers have shown in a piece of article that there are five common forms of medical billing scams.

They are termed: upcoding, inflated hospital bills, service unbundling, self-referrals, and phantom billing.

Medical bills should not be taken lightly. If a person or organization is determined to have been scammed or to have manufactured a fake bill, they will face certain legal consequences.

This is evident in the September 2011 upcoding allegations against the University of Texas Southwestern medical centre in Dallas. To resolve this allegation, the University agreed to pay $1.4 million. Some sources later disclosed that Texas said it was a mistake.

Have you recently noticed a fake bill passed to you? Here is an ultimate guide on what to do if you spot one.

Report the act to the right authorities to be sure whether or not it is fake.

You must also look out for your information (such as insurance ID) on the bill carefully to ensure that they are correctly entered.

You should request an itemized list from the providers of the bill. It is a breakdown of what made the total amount you are asked to pay. This should always be one of the first things you request before accepting a bill you perceive to be fake.

Instantly get in touch with your healthcare providers.

Verify your billing code. When everything seems invalid, the next thing to consider is whether the code entered on your bill corresponds with what your healthcare providers chose to forward to your insurers.

Having examined what you should do after spotting a seemingly fake bill, let’s talk about some other points that will be essential to you.

Factors To Consider To Avoid  Medical Billing Fraud

The tips below are some factors you should consider in figuring out a fake medical bill and ultimately avoid them.

Give Careful Attention To Each Item On Your Bill

It is good to take our time in whatever we do, even though the place of urgency has to be acknowledged. As we discussed the factors to avoid medical billing fraud, we learned that not paying attention to details has made many fall for the simple tricks in previous years.

For example, if your medical bill came online, we would have encouraged you to pay particular attention to the URL. However, because you are not expecting it that way, you need to search for a few indicators on every account you receive to evaluate whether or not it is fake.

First and foremost, check to see if the service date on the bill corresponds to the last time you had treatment. Do you have any means to contact your provider about the bill? If your answers to these questions are no, it is most likely a scam medical bill.

Maintain Open Communication Lines And Work With The Billing Office

If you have had good communication lines with your billing office before receiving a bill, it will be easier for you to reach your healthcare providers and make some quick inquiries to ensure they approve the bill.

We explained that there are several methods to contact the office that issued you the bill and that it should be available on paper. Let us look at why this is essential and how it may assist you in avoiding being scammed.

If it is fake, you will likely not get any means to contact the billing office on the bill. In a few smarter cases, you may get some contact options.

Try to reach your healthcare provider (or so) through the contact options and make some inquiries to be sure it is a valid bill. Part of the questions you should ask should include the description of the service you received and when.

Make Your Report Via The Proper Channels

img source: iusb.edu

In situations like medical billing fraud, it is essential to contact legitimate corporations or groups that may assist you. You can avoid getting scammed when you send a report through the proper channels. You can protect yourself from losing money and valuable data by doing so.

Furthermore, as soon as you notice you are about to get scammed, reach out to professionals, specifically your healthcare providers or doctors, to seek advice.

These persons are in the greatest position to connect you with the next course of action. If a fraud attempt is to be legally filed against you, professionals will inform you when, how, why, and to whom. This is something you want to be sure of.

Do Not Be Afraid To Seek Help

You should instantaneously seek help! The saying goes that he who asks a question is a fool for a minute, while he who doesn’t ask is a fool forever.

If the help you want to seek is to get answers to some questions, you shouldn’t be scared or rather shy in your 40s to ask a 23-year-old biller or others that could provide you with relevant answers.

It is important you seek help from experts when you run into problems of this kind. As a way of avoiding falling victim to fake medical billings, you should immediately seek help from more advanced people when you notice a suspicious bill.

Keep Track Of Your Bills

Keeping track of your bills will be easier with proper organization. The ‘organizing’ portion of the item should be summarized as follows:

  • Identify every medical billing paper you get.
  • Separate invoices from EOBs.
  • Categorize bills depending on your insurer’s response.

However, why keep track? This will help you easily determine whether you have received the last bill you’re supposed to get or whether it’s not time to get another one. With this, you should also be able to compare any bill-inspiring doubt with the one you identify as genuine.

Step-by-step Guide To Take In Place If You Spot A Fake Medical Bill

Let’s see how you can handle the case of a fake medical bill you discovered in a gradual process. There are two major steps you’d have to take.

First and foremost, the first thing you should consider is confirming that the bill is truly fake. Other steps depend on how you would like to verify it.

You can do so by contacting the biller through the contact options on the bill, checking if every piece of information provided correctly matches yours and whether you received treatment on the date issued on the bill, among other things we have examined earlier.

Secondly, report to professionals to get the most appropriate guide. Now that you are sure you received a fake bill, you should report the biller to the proper channels.

How To Keep Your Medical Information Safe From Theft

If they have to be disposed of, shred your bills and EOB papers first. So others can’t access them.

You can best keep your information online, using security software.

Avoid using public WiFi networks when accessing your medical billing information. Prevent any obvious ways hackers can get hold of your medical information.

Do not share too much sensitive information (passwords) with your healthcare providers. Ensure you tell them not more than they need to know.

Either choose to use a digital or paper record. In most cases, using the two can increase the risk of getting your information exposed.

What To Do If Your Medical Information Is Being Misused

It is unethical for a doctor or any other healthcare practitioner to reveal your medical information to outsiders. Thus, they must keep it confidential. But what if you discover that your information is being mismanaged?

You have several options if your medical information is being utilized inappropriately or illegally. The first thing you should do as a patient is always to keep your sensitive data safe.

You should contact your healthcare provider since they are the only people you know with access to your information. Visit them to report the case and tackle issues that may arise as a result on time.


Do you suspect you could be a victim of a scam? Keep an eye out. Have you confirmed that the bill you received is a forgery? Please report to the proper office. And if your country operates a universal healthcare service, you don’t have to worry about any medical bills you may receive.

According to research from 2018, 75% of American individuals were shocked by the number of medical costs they expected to be covered by insurance; 20% of this figure was attributed to doctors who were not part of the system.

The question is, what happens to the remaining 55%? We encourage you to be extremely cautious about the kind of medical bills you acknowledge.

Finally, if you find a fraudulent bill, you can report it to the authorities. There are several methods for achieving this; thankfully, this article has revealed them all to you! The ultimate objective is to keep your money safe and the economy in good shape. Thanks for reading!