There are several ways of preventing opportunities for a provider to commit fraud. The following procedures can also protect you from becoming a victim.

• Never sign a blank insurance claim form.

• Keep detailed records of the treatment you receive and the amounts that you pay.

• Ask your providers what prices they charge.

• Know what your benefits are.

• Review your Explanation of Benefits statements.

• Question your health provider and ask for clarification if you see problems or inconsistencies on your bills.

• Demand detailed bills for services and check them closely for accuracy.

• Make sure "free services" aren't charged to your insurance carrier.

• Keep your insurance identification number secure.

• Be aware that if someone says they can bill your insurance program so that an uncovered treatment is paid for, you are being pulled into an illegal scheme. You could lose your insurance coverage, lose your job, be arrested, or be fined or jailed.

• Contact the authorities if you think you have knowledge of, or have been involved in, a fraud.

Some tips to insure you are not being taken advantage of when purchasing insurance. Read more

Subscriber/Member Do's

• Check your Explanation of Benefits statement for accuracy.

• Question any charges or services that appear to be incorrect.

• Report any suspicion of fraud.

• Keep your insurance information secure.

• Know what your benefits and responsibilities are.

• Get a receipt for any payments you make.

Subscriber/Member Don'ts

Do not ask your dentist to:

• Submit a date of service that is not accurate.

• Submit for a dental service or procedure that was not rendered.

• Omit other insurance carrier coverage and payments from your claim form.

• Omit information regarding any discounts extended to you, or any intention to waive your copayment responsibility.

• Change the amount of the fee charged for any of the services billed for on your claim form.

If you are submitting your own claim form, do not:

• Alter any fees or dates of service.

• Change any procedure codes.

• Add any procedure codes that were not performed.

Do not loan your insurance information to any other individual. Remember, anyone who knowingly benefits from an act of insurance fraud is equally guilty of the offense of healthcare fraud.

Knowingly submitting a claim form that reflects any of the above may result in the violation of:

• The Delta Dental of New Jersey Participation Agreement

• The New Jersey State Board of Dentistry Administrative Codes

• The New Jersey Insurance Fraud Prevention Act

• The New Jersey Health Care Claims Fraud Act

• In Connecticut, the General Statutes of Connecticut

• The Federal Health Care Claims Fraud Act