Which of the following is a NOT a warning sign of health care provider fraud?

The correct choice, which identifies a statement that is not a warning sign of health care provider fraud, is based on the understanding of what constitutes typical indicators of fraudulent activity within the healthcare sector.

An unusually small number of claims for reimbursement can signal that a provider may not be billing accurately or could be avoiding legitimate claims, potentially indicating fraud. Altered medical records suggest misconduct in documentation practices, which can often relate to fraudulent behavior aimed at maximizing reimbursements or avoiding penalties. Similarly, pressure for rapid processing of bills or claims can create an environment where errors or unethical behaviors are more likely to occur, thereby serving as a warning sign for potential fraud schemes.

In contrast, unusually high profits compared to similar businesses in the same region do not inherently indicate fraud. Many legitimate factors can lead to higher profitability, such as efficiency, market demand, or quality of care that attracts more patients. Therefore, this does not qualify as a warning sign of fraud, as high profits alone are not sufficient evidence of wrongdoing without additional context involving billing practices or claims submissions. Understanding financial performance in relation to operational practices is key in distinguishing between legitimate business success and opportunistic fraudulent behavior.