Fraud and Abuse
United Concordia takes a strong stand against fraudulent and abusive practices. Fraud and abuse can take many forms, including:
- Submitting claims for services not rendered
- Submitting claims for non-covered services disguised as covered benefit services
- Identity thefts submitting claims for a non-eligible individual as a covered beneficiary
- Duplicate claim submissions
- Misrepresentation by the dentist of his or her credentials
- Concealment of information (by the dentist) regarding business practices which disqualify him or her as an authorized ADDP provider
- Improper billing practices, including submitting claims for unnecessary dental services
- Routine waiver of member cost-share
Reporting Fraud and Abuse
If you believe a dentist or entity has received insurance money through the submission of a false claim, you should report this information to the Special Investigations Unit (SIU). United Concordia provides several ways for enrollees to contact the SIU:
- Use the Online Fraud Complaint Form
- To submit written correspondence, download the pdf file for printing and send to:
United Concordia Companies, Inc.
Special Investigations Unit
4401 Deer Path Road
Harrisburg, PA 17110
- Contact the toll-free "Fraud Hotline" at 1-877-968-7455.
The SIU maintains a 24-hour confidential voice mailbox for reporting suspected fraud.