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Provider Resources |
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| Anti - fraud |
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| Health care fraud is a problem that affects everyone. Dollars lost to fraud result in higher premiums . Nationwide Health Plans is committed to the fight against fraud and you are a valuable resource. To assist us we ask you to remain vigilant and report fraud whenever you suspect it. |
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| What information is required to report fraud? |
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- Name of the person or health care provider suspected of being involved in the fraud, including the address if known.
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- Date(s) of service and claim number(s) in question.
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- Patient's name and NHP member number.
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- Narrative description of the allegation. Include as much detail as possible.
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- Your telephone number or email address.
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| What happens after fraud is reported? |
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- You will receive an acknowledgement of your referral when Nationwide Health Plans Anti-Fraud* Unit receives your allegation.
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- Each allegation will be investigated. (You may be contacted for additional information if you indicated it is okay).
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- You will be advised of our findings when the investigation is complete.
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| * Once received , the identity of the complainant / member will be kept strictly confidential. |
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| Questions about fraud? |
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fraud faqs |
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What to do if you suspect fraud
To report suspected cases of fraud provide the necessary information and respond by:
- 24-hour fraud hotline: (614) 854-3234 or 1-(800)-626-2904
- email: efraud@nationwide.com
- write to:
| California Complaints |
Nationwide Health Plans
Special Investigations Unit, HM-90
1651 Exposition Blvd, Suite 100
Sacramento, CA 95815-5103 |
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| Ohio Complaints |
Nationwide Health Plans
Special Investigations Unit
5525 Park Center Circle
Dublin, OH 43017-3584 |
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