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Fraud & Abuse Prevention UPMC Health Plan has established a Special Investigations Unit (SIU) to detect, prevent, and investigate suspected insurance fraud and abuse. Intentional fraud and abuse victimizes the UPMC Health Plan, its officers, employees, policy holders (group accounts, members, subscribers, and/or individual enrollees), business partners, and the entire insurance community.Our commitment is to detect, prevent, and prosecute both internal and external fraud against UPMC Health Plan, while still meeting our business obligations. We will investigate all allegations of fraud or abuse committed by providers, members, employees, and any other entity doing business with UPMC Health Plan. The SIU is UPMC Health Plan's corporate focus against insurance fraud. We will investigate all allegations of fraud and/or abuse against UPMC Health Plan. The Health Plan has no tolerance for fraud-related activity, and will refer all fraudulent acts to the appropriate regulatory health care oversight or law enforcement agency. If you would like to report suspected fraud or abuse, a hotline has been established for that purpose. The number is 1-866-FRAUD-01. To Report Possible Fraud:Call 1-866-FRAUD-01Check our site often for further fraud related updates Send suggestions to: |
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