How to report fraud and abuse

If you suspect someone of fraud or abuse, please help us keep costs down. Contact us immediately.

You do not have to give your name. You may remain anonymous.

Information we'll ask you for

• The name of the Priority Health member or doctor, hospital, or other health care provider involved
  
• The Priority Health member's card number (if you have it)
• The date that the service or incident took place
• The amount of money that Priority Health paid (if possible)
• A short description of your concerns or of the acts that you suspect involve fraud or abuse
• You may share your name and telephone number with Priority Health and request that your name not be used. Your name will be left out of the report, but if you provide your name we will be able to call you and ask any questions we have.
  

Jump down this page to:

• How to notify Priority Health
• How to notify Medicaid
• How to notify Medicare

How to notify Priority Health of suspected fraud, waste or abuse

By phone

Call Customer Service at 616 942-4765 or 800 942-4765
Monday through Thursday 7:30 a.m. to 7:00 p.m., Friday 9:00 a.m. to 5:00 p.m., Saturday 8:30 a.m. to 12:00 p.m.
OR
Call the 24-hour Compliance Hotline at 800 560-7013.

By mail, fax or e-mail

1. Download, complete and mail the Fraud, Waste & Abuse Report Form (56KB PDF)
2. Send the form to:

Fraud and Abuse Program, Finance Department
Priority Health, MS 2305
1231 East Beltline NE
Grand Rapids, MI 49525-4501
OR
Fax it to "Fraud & Abuse Program" at 616 942-7916
OR
E-mail it to  brenda.gross@priorityhealth.com or kathy.kilduff@priorityhealth.com

How to notify the Medicaid and MIChild programs

If you suspect someone of committing fraud or abuse, you may also contact the State of Michigan directly. You do not have to give your name. You may remain anonymous.

Call the State of Michigan toll-free at 866 428-0005
OR
Use the online complaint form at the michigan.gov website.
OR
Write to: 

Medicaid Integrity Program
400 South Pine, 6th Floor
Lansing, MI  48909

How to notify Medicare

If you suspect someone of committing Medicare fraud or abuse, you may also contact the Office of the Inspector General directly. You do not have to give your name. You may remain anonymous.

Call toll-free 800 447-8477
OR
Go to www.oig.hhs.gov/fraud/hotline
OR
Write to:

Office of the Inspector General
Department of Health and Human Services
Attn: HOTLINE
P.O. Box 23489
Washington, DC  20026

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