Fraud and healthcare
Health care fraud is a serious issue and it can affect everyone, including you.
Results of health care fraud may be inaccurate medical records, lost benefits, increased premiums and medical expenses.
Beware of potential scams
Protecting yourself from identity theft during Open Enrollment
Identity theft occurs when someone obtains your personal information and uses it to bill for medical supplies and services. It is always important to protect your Medicare and health plan insurance numbers, but be especially careful during Open Enrollment. Never give out your Social Security, Medicare or health plan insurance numbers to someone you don’t know. And of course, carefully review your plan statement to ensure all the information is correct.
Besides those precautions, be wary if any of the following occur:
- Someone says you are eligible for a refund based on last year’s premium or because you have reached your prescription drug plan “donut hole” and they need your Medicare or health plan insurance number to issue the refund to you.
- A company offers you free medical supplies, gift cards or other offers if you provide your Medicare or health plan insurance number.
To report suspected identity theft or fraud, call 1-866-595-8495 or use our online form.
Beware of 'free' services
Be wary of persons calling you and offering “free” gift cards in exchange for your insurance or credit card information.
To protect yourself never give your personal information to someone you don’t know. If you receive a telephone call or voice message, hang up and do not press any keys or numbers when prompted even if it is to be removed from their list.
If you suspect services have been submitted to your Prevea360 Health Plan account that you did not receive, contact us on our Fraud Hotline 1-866-595-8495 or use our form.
Resources
- Coalition Against Insurance Fraud
- National Health Care Anti-Fraud Association
- State of Wisconsin Department of Safety and Professional Services (DSPS)
- Health and Human Services Office of Inspector General
Report fraud or abuse
Use our online form to report suspected health care fraud or abuse. This form is completely confidential and you may remain anonymous. Important information you will need to provide to allow the issue to be reviewed is:
- The name and address of the complaint subject
- An explanation of what you suspect is fraud or abuse
- Your complete contact information, including your health insurance identification number, unless you wish to remain anonymous
If you have questions about fraud awareness or to discuss a potential case of abuse, contact us at 1-866-595-8495 or use our form.