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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
          Fax: 717-260-7204
  • Contact the toll-free "Fraud Hotline" at 1-877-968-7455.

The SIU maintains a 24-hour confidential voice mailbox for reporting suspected fraud.

United Concordia Fraud Success Stories

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