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Fraud, Waste, and Abuse

IlliniCare Health wants to find and stop fraud, waste, and abuse. We want you to help us. We want our doctors to help us. Please tell us if you see something that you do not think is right.

What does this mean?

Fraud: Intentional deception or misrepresentation to obtain the money or property of a health care benefit program (by means of false or fraudulent pretenses, representations, or promises).

Waste: Using services or other practices that result in costs not needed.

Abuse: Getting money for items or services when there is no legal reason for that payment, but without knowing and/or intentional misrepresentation of facts to obtain payments.

Here are some phone numbers to stop Fraud, Waste, and Abuse

If you think someone is committing fraud and abuse tell us. Call Member Services at 1-877-941-0482 or call our Fraud and Abuse hotline at 1-866-685-8664 (TTY: 711). You can also call our Ethics and Compliance Toll-Free Helpline at 1-800-345-1642 (TTY: 711).

Report abuse or fraud

All information will be kept private. Stopping fraud and abuse will provide more time and money for your healthcare needs. We will not tell anyone what you tell us. Stopping fraud and abuse will offer more money for your healthcare needs.

Additional ways to report Fraud, Waste, and Abuse are by calling one of the following agencies:

  • IlliniCare Health Provider Services: 1-866-329-4701 (TTY: 711)
  • Office of Inspector General: 1-800-368-1463 (TTY: 711)
  • Department on Aging: 1-866-800-1409 (TTY: 711)
  • Senior Help Line: 1-800-252-8966 (TTY: 711)
  • Department of Public Health: 1-800-252-4343 (TTY: 711)

For questions call IlliniCare Health Member Services at 1-877-941-0482. Hours are 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on holidays, you may be asked to leave a message. Your call will be returned within the next business day. TTY users call 711. The call is free.

 

 

Last Updated: 02/08/2018
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