Policies & Procedures
Page last updated: Sep 14, 2022
© Copyright 2022 – Care N’ Care – All rights reserved. Y0107_23_099_M ACCEPTED
Care N’ Care is committed to detecting and fighting healthcare fraud. Working with law enforcement when necessary, Care N’ Care evaluates all allegations of fraud, waste and abuse.
You can help us fight fraud by paying close attention to your medical and prescription drug benefits. Review every Explanation of Benefits (EOB) for accuracy. If you find a suspicious charge on your EOB or Medicare Summary Notice, call your provider first. It could be a simple error that can be easily corrected. If you still suspect fraud after speaking with them, you can contact Care N’ Care at 1-877-374-7993 (TTY 711). Care N’ Care employees are trained in detecting fraud, waste and abuse and will evaluate your call and determine the appropriate course of action. To report healthcare fraud, waste, or abuse, call the Care N’ Care Compliance Hotline at 1-844-760-5838. Reports made through the compliance hotline can be made confidentially or anonymously, 24 hours a day, 7 days a week. To submit a written report, write to: Care N’ Care, Attn: Compliance Department, 1603 Lyndon B. Johnson Freeway, Suite 300, Farmers Branch, TX 75234.
You can also contact the Office of the Inspector General Hotline; this provides a confidential means to report information.
Examples of potentially fraudulent activities
- You did not receive a medication listed on your EOB.
- You received a different drug than what is listed on your EOB.
- You received a different quantity of drug than what is listed on your EOB.
- Someone asked you to sell your member ID card.
- Someone asked you to use your member ID card.
- Someone offered you cash to purchase a prescription drug or to disenroll from your current plan.
Care N’ Care materials are available in other formats, call toll-free at 1-800-994-1076 (TTY 711) October 1– March 31, 8 am – 8 pm, (CST) seven days a week or April 1 – September 30, 8 am – 8 pm (CST), Monday through Friday.
© Copyright 2022 – Care N’ Care – All rights reserved. Y0107_23_099_M ACCEPTED
