Fraud, Waste, and Abuse

Help prevent fraud, waste, and abuse

Members can help First Choice VIP Care Plus (Medicare-Medicaid Plan) uncover provider fraud, waste, and abuse. You should keep track of the following things when you visit a health care provider:

  • What was the date of the health care service?
  • Where did the service take place?
  • Who provided your health care?
  • What services did you receive during the visit?
  • What other tests did the doctor order?
  • Did the doctor schedule more visits?

It's important to track your past claims in the member portal. You may also track the status of your claims by calling Member Services. Report any suspicious claims, like provider visits you didn't go to. Call First Choice VIP Care Plus if you think the provider may have billed you wrongly or offered a service you didn't think you needed.

Please remember not to:

  • Give your ID card or numbers to anyone other than your primary care provider (PCP), clinic, hospital or other health care provider.
  • Ask your PCP or any other health care provider for medical services or supplies that you don't need.
  • Sign your name to a blank form.
  • Share your medical records with anyone other than your PCP, clinic, hospital or other health care provider. First Choice VIP Care Plus has a team that works hard to identify and prevent fraud, waste, and abuse. However, we still need all providers and members to report possible fraud, waste, and abuse.

Call the Fraud Hotline at 1-866-833-9718. You have the option to remain anonymous at all times.