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Prospective Members, Enrolled Members

and Provider Inquiries: 800-405-9681 (TTY 711)

What is Fraud, Waste and Abuse?

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: The over-utilization of services or other practices that result in unnecessary costs.

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

What can you do to help prevent, report, and stop Fraud, Waste, and Abuse?

Report potential fraud:

The PPHP Compliance Hotline 1-833-213-0636 is available 24 hours a day/7 days per week to our employees, members, providers and FDRs. The hotline allows for anonymous reporting of potential non-compliance and FWA matters. We also maintain a Compliance email address: compliance@pphealthplan.com.

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Page Last Updated:  5/19/2019

Provider Partner Health Plans are HMO-SNPs with Medicare contracts. Enrollment in Provider Partner Health Plans depends on contract renewal. Y0135_PPHPWEB_2021