Skip to Content (Press Enter)

Report Possible Fraud and Abuse

Please call our fraud hotline at 1-800-372-8321 or complete the following form if you suspect an incident of fraud or abuse has occurred. Your privacy is important to us; all referrals are confidential.

Your Information
Would you like to remain anonymous? *    
First Name:
Last Name:
Street Address:
Street Address 2:
Email Address:  
Phone Number:  
Member ID Number:
(can be found on your health insurance card)
Provider/Person You Are Reporting
First Name:
Last Name:
Provider Number:
(if applicable)
Facility/Clinic Name:
(if applicable)
Type of Provider:
(if applicable)
Summary of Complaint *