Antifraud Policy and Procedures Sample Clauses

Antifraud Policy and Procedures. HPCC makes every effort to detect, investigate, and prosecute any incidents of fraud at any level within its Behavioral Health Service. HPCC contracts with a special investigator trained in fraud investigation to assist us in investigating fraud. In the event that HPCC detects any fraudulent activity on the part of a Provider, the Provider’s contract with HPCC will be terminated. If HPCC detects any fraudulent activity on the part of an Enrollee or Employer, HPCC will deny Enrollee any additional benefits under Enrollee’s Group Plan and may terminate Employer or the Enrollee. Additionally, HPCC will prosecute fraud to the fullest extent of the law. We also cooperate with all government agencies in a combined effort to prevent and prosecute fraud on the part of both Providers and Enrollees.
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Antifraud Policy and Procedures. Xxxxxx makes every effort to detect, investigate, and prosecute any incidents of fraud at any level within its Behavioral Health Service. Xxxxxx contracts with a special investigator trained in fraud investigation to assist us in investigating fraud. In the event that Xxxxxx detects any fraudulent activity on the part of a provider, the provider's contract with Xxxxxx will be terminated. If Xxxxxx detects any fraudulent activity on the part of an enrollee or Employer, Xxxxxx will deny enrollee any additional benefits under enrollee's Group Plan and may terminate Employer or the enrollee. Additionally, Xxxxxx will prosecute fraud to the fullest extent of the law. We also cooperate with all government agencies in a combined effort to prevent and prosecute fraud on the part of both providers and enrollees.
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Antifraud Policy and Procedures. HPCC makes every effort to detect, investigate, and prosecute any incidents of fraud at any level within its behavioral health care service. Fraud hurts everyone through higher taxes to fund government health care plans and higher premiums for private health coverage. In order to insure that our enrollees do not have to pay for the high cost of fraud, we encourage you to report fake claim schemes. We are here to help you recognize and report any incidents or suspected incidents of fraud you discover. If you notice that a claim submitted to HPCC by your provider’s office includes a charge for a therapy session you did not receive, you may have detected health care fraud. The first step is to notify your provider of the incorrect charge. The second step is to notify HPCC at 0-000-000-0000. HPCC wants your help to identify potentially fraudulent or abusive claim activities. If you know or suspect illegal or wrongful billing practices by a provider or an enrollee, please tell us. We will treat any information you provide with strict confidentiality. We promise not to disclose your identity unless you are willing to voluntarily give us your written permission. Furthermore, state and federal laws protect the confidentiality of your medical records. We will not release any medical information without lawful authorization. HPCC contracts with a special investigator trained in fraud investigation to assist us in investigating fraud. In the event that HPCC detects any fraudulent activity on the part of a provider, the provider’s contract with HPCC will be terminated. If HPCC detects any fraudulent activity on the part of an enrollee, HPCC will deny enrollee any additional benefits under enrollee’s Group Health Plan. Additionally, HPCC will prosecute fraud to the fullest extent of the law. We also cooperate with all government agencies in a combined effort to prevent and prosecute fraud on the part of both providers and enrollees. Organ and Tissue Donation. Approximately 77,000 people in the U.S. are on the national waiting list for an organ. An average of 15 people die every day because not enough organs are available. Organ and tissue transplantation saves lives. For example, about 60 people receive life-enhancing organ transplants each day and about 82% of patients who receive a donated kidney are still alive 5 years later. For more information on how to become an organ and tissue donor, visit the U.S. Department of Health and Human Services website at xxx.xxxxxxx...
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Related to Antifraud Policy and Procedures

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