Health Care Provider Fraud

Report health care provider fraud
in Washinton State

  • Online or
  • By phone: 1-888-811-5974

Spotting the red flags

Below are some behaviors that can indicate fraudulent activity by a health care provider:

Providers who…

  • Bill for treatment on consecutive dates of service for minor injuries.
  • Work with the same attorney(s) that repeatedly have similar questionable claims.
  • Bill for services that did not occur.
  • Bill for services that were not received.
  • Bill for unnecessary medical equipment.
  • Pay an agent or other person for referrals.
  • Charge workers for medical treatment on their claims.

Provider offices where you observe…

  • Increased injury claims after a business closure.
  • Claimants move away but bills are still being sent on their behalf.
  • High volumes of prescription drugs not appropriate to the injury.
  • Claimants using prescription drugs for uses other than intended (selling, trading for street drugs, or as payment for services).
  • Interpreters acting as advocates on the claim, steering the injured worker to different clinics, physical therapists, etc.

Need help determining when to report?

Contact the provider fraud detection staff at 360-902-6847 or ProviderFraud@lni.wa.gov.

Other health care provider concerns

If you have concerns about a provider that do not appear to be related to the indicators listed above, File a complaint about a doctor.

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