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Sales

855-343-0361
Mon - Fri from 8 a.m.- 5 p.m.

Medicare Options

800-232-4967
Mon - Fri from 8 a.m.- 5 p.m.

Customer Service

Need Help?

Visit our Help Center

Sales

855-343-0361

Mon - Fri from 8 a.m.- 5 p.m.

Medicare Options

800-232-4967

Mon - Fri from 8 a.m.- 8 p.m.

Report Fraud, Waste or Abuse

Name and contact information of individual reporting the alleged fraud or abuse.

Use this form to report any known or suspected activities. All reports received are confidential and you will never experience retaliation as a result of making a good faith report. You may also report anonymously by calling the Fraud Hotline at (800) 392-9249.

Name of Reporter

Phone of Reporter

Email of Reporter

Classification of Reporter*

Description of Complaint and/or Allegation*

Complaint Source: (How did the reporter find out about this issue?)*

I prefer not to be contacted.

Has the reporter previously reported this issue?

Yes No

Who is suspected of committing fraud, waste or abuse?

Classification of Suspect*

Please complete the below sections with as much information as possible.

First Name

Last Name

Employee Department

Employee ID

First Name

Last Name

Phone Number

Producer Number

First Name

Last Name

Street Address

City

State

Zip Code

Phone Number

Member ID

First Name

Last Name

Street Address

City

State

Zip Code

Phone Number

Company Name

Provider NPI

Provider TIN

First Name

Last Name

Street Address

City

State

Zip Code

Phone Number

Company Name

Vendor Number

First Name

Last Name

Street Address

City

State

Zip Code

Phone Number

Type of Suspect

By using this site, you agree to our use of session replay tools to collect real-time information about your use of our site. We only use the information to optimize the performance of our website, fix errors and prevent fraud. Selecting "no" keeps the information collected anonymous.

Yes No