Fraud Prevention

Fraud in health care is becoming a larger and larger problem every year.  The 2009 federal Stimulus Bill/Recovery Act has focused on informing consumers and extended efforts to detect fraud in the health care system. Columbia United Providers (CUP) works closely with State and Federal agencies to detect, correct, and prevent fraud.

What is health care fraud?  Some examples include:

• Billing for services that weren't provided.
• Using someone else's identity (ID) to obtain benefits or receive payment.
• Billing for illnesses that are more severe than actual symptoms indicate.

 Here are a few helpful tips on how you can help prevent health care fraud:

• Do not give your CUP ID number to anyone except your doctor, clinic, hospital, pharmacy or other health care provider.
• Do not let anyone borrow your CUP ID, State Services card, or Social Security card.
• Never sign a blank insurance claim form.
• Review your statements from hospitals and doctors to make sure they are accurate.

If you think fraud has taken place, please report it right away so we can follow up on your concerns and assure that billings are accurate.  Your reports are kept private. You may report your concerns without giving your name. 

For More Information:

Washington State Department of Social & Health Services (DSHS) Office of Fraud & Accountability:
The Office of Fraud & Accountability (OFA) has the authority to conduct investigations related to claims of fraud within programs administered by DSHS.  Investigations focus on Welfare eligibility issues and vendor fraud.  Investigators work with staff at the Community Service Offices statewide; with county prosecutors; and with local, state, and federal law enforcement agencies when necessary.

• DSHS Fraud Reporting
• Washington State Welfare Fraud Hotline: 1-800-562-6906

      Contact CUP's Compliance Administrator:

• Confidential Phone Voice Mail:  (360) 449-8883
• Under 'About Us' on the menu tab above, choose 'Contact Us' from the drop-down list and fill out the form

     Additional health care compliance and anti-fraud & abuse information:

• Medicaid Fraud Information
  Phone: (360) 586-8888
  Mail: Welfare Fraud Hotline  PO Box 45817   Olympia, WA  98504-5817 
  Fax written complaint to Attention Hotline at 360-664-0032
  Email:  Hotline@dshs.wa.gov

Fraud Prevention Training Offered by OIG ~

The Office of the Inspector General has developed a fraud prevention training site.  The False Claims Act provides a way for the government to recover money when someone submits false claims for payment to Medicare/Medicaid programs.  The training videos include examples of claims that may be false and discusses what providers should do to ensure the claims they submit are true and accurate.

Click on this icon to access the training videos.