While it is difficult for the government to identify fraud, it is much harder for any facility to hide the fraud from the healthcare workers who deal with patients and fill out claims forms.
You have been asked to change details on completed claim forms: Unless there is an error, completed forms should not be changed before they are submitted. If you are being asked to change details on a regular basis, it may be because the changes are part of a fraud scheme.
You have been threatened with disciplinary action for asking that rules be observed: As part of their licensing, most doctors, nurses, and other caretakers are required to learn certain laws. If you have complained about laws that are not being followed, and as a result been threatened with disciplinary action, fraud may be taking place.
Limited opportunities for review: Many care centers have individuals or entire departments who are tasked with reviewing information to ensure compliance with the law. If the procedures of the care center prevent certain information from being reviewed by these departments, fraud may be taking place.