Waste, Fraud, and Abuse

If you think you or one of your dependents has been a victim of health care fraud, waste and abuse, please fill in as much of the information as you can below and click the submit button, or call the Member Services number on the back of your ID card to report it right away. For more information, visit www.fighthealthcarefraud.com.

Information on the Suspected Member or Provider

First Name

Last Name

Middle Initial

Suffix

Provider or Practice Name

Street Address

Suite

City

State

Zip

Telephone

ext

Tell us about the activity that may be waste, fraud or abuse

Give details that tell us who, what, when, where, why and how.

Some examples are:

Billing for services you did not receive.
Someone using your identity to receive medical services.

Enter any information about the suspected member or provider:

How can we contact you?

Please provide your contact information so we can contact you if we have questions. Your identity will be protected to the extent allowed. You also have the right to remain anonymous when reporting fraud, waste and abuse.

First Name

Last Name

Middle Initial

Suffix

Your Street Address

Suite

City

State

Zip

Your Telephone

Your Email Address

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