Report Suspected Fraud and Abuse

Please call our fraud hotline at 1-833-663-8714 1-833-663-8714 or complete the following form if you suspect an incident of fraud or abuse has occurred.

In order to quickly investigate your report, please provide as much information as possible.

* Indicates a required field

Who do you suspect is committing fraud?

Prefix

Suspected Provider's Name *

Suspected Provider's Name is required.

Suffix

Type of Physician

If applicable.

Address *

Address is required.

City *

City is required.

State *

State is required.

Zip Code *

Zip Code is required.

Suspected Provider's Phone Number

Enter number in the format (000) 000-0000.

What fraudulent activity occurred? *

Please provide as much detail as possible.

Fraudulent Activity is required.

Contract Number

If the fraud involves services provided to you.

Any additional comments?

May we contact you? (If additional information is necessary.)

Name

Contact Phone Number

Enter number in the format (000) 000-0000.

Email Address

Invalid email address format: name@domain.com.