Understanding Health Care Fraud, Waste and Abuse
Reporting suspected fraud is simple – and it’s important.
When you report a situation that could be considered fraud, you’re doing your part to help save money for the health care system and prevent personal loss for others. Taking action and making a report is an important first step. After your report is made, UnitedHealthcare works to detect, correct and prevent fraud , waste and abuse in the health care system.
Is it Fraud?
Understanding health care documents isn’t always easy. If the information you receive isn’t what you expected or doesn’t make sense to you, it might seem like fraud. However, it might simply be an error.
Review Frequently Asked Questions first to decide if your concern is fraud.
If it’s not fraud, but seems to be an error, you’ll get answers more quickly by calling the number on the back of your Health Plan ID card to talk to a Member Services Representative.
Fraud has a big impact – on everyone.
Fraud affects all of us in many ways. In fact, the National Healthcare Anti-Fraud Association estimates that fraud costs Americans at least $33 billion to $55 billion annually – that’s approximately 3-5% of the nation’s health care spending of $2.26 trillion.
Fraud can have a personal cost too. It can cause mistrust between doctors, patients and health care insurers. That’s because in many cases, fraud involves harmful actions, like getting prescriptions for the wrong medications, receiving improper medical services and being misguided by needless tests and diagnoses.
If you have a concern, you can make a report online or via phone call. You can call 1-844-359-7736 or use these buttons to report online:
Report Medicaid Fraud
- You can report Medicaid Fraud above and your state will receive a notice about your report.
- Since Medicaid can be different in each state, you can also visit your state Medicaid site to get more information.
Please note. When you start a report, you will be sent to a third party website, NAVEX, the company that handles fraud tips for UnitedHealthcare. This is to protect your information and ensure that fraud reports are handled in a fair and unbiased manner.