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How to Protect Yourself from Fraud

Keeping Your Information Safe

Many scam artists have found ways to deceive and steal financial and personal information. It’s important to protect yourself from financial and insurance fraud. To keep your information safe, use the following tips.

  • Never sign blank insurance claim forms.
  • Do not do business with door-to-door or telephone salespeople, or companies that advertise services or medical equipment as free or available for no direct cost to you.
  • Don’t give your personal information to anyone who calls you or comes to your home uninvited selling health care products. Generally, no one should do this.
  • Only give your insurance identification and Social Security number to those who have provided you with medical services.
  • Keep accurate records of all your health care appointments and verify your explanation of benefits and all bills for services. Report any services you did not receive to Network Health.
  • Keep any receipts from providers for health care services and use those receipts to check for any errors on the explanation of benefits statements.
  • Always watch your credit card and bank statements for any improper billing activity or fraudulent withdrawals.
  • Monitor your credit report regularly.

Sometimes scams are not reported because people are ashamed or embarrassed. It is important to know it’s not your fault. If you believe you are the victim of an insurance scam, we are here to assist you. Email us at paymentintegrity@networkhealth.com.

You can always call our Incident Hotline to report and discuss activities or occurrences you believe are improper. The hotline is confidential, and you may report concerns anonymously. Your concerns will be investigated, and appropriate action will be taken to address the problem. The Incident Hotline number is 877-700-7020.

 

What You Should Know About Fraud

Network Health takes health insurance fraud seriously. Insurance fraud costs millions of dollars each year, and it results in higher health care costs. Our team investigates all reports we receive. Tips from our members are critical in helping us identify fraud, waste and abuse. We urge you to contact us if you feel you’ve been impacted.

Below are some examples of possible fraud.

  • A health care provider bills for services you never received.
  • A DME supplier bills for equipment different than what was ordered and provided or was unsolicited.
  • Someone uses another person’s member ID card to get medical care, supplies or equipment.
  • Misrepresenting  alternative medicine or cosmetic procedures as covered plan benefits.

 

If you suspect fraud, here’s what you can do.

  • Call your health care provider to make sure the bill is correct.
  • Call the Member Experience Team: 920-720-1300 or 800-826-0940 (TTY/TDD: 800-947-3529) Monday-Friday, 8 a.m. to 5 p.m. (Monday-Friday 8 a.m. to 4:30 p.m. for State of WI employees)
  • Email us at paymentintegrity@networkhealth.com