How to report fraud and abuse

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

Page last updated on: 3/04/25

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.

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.
  • Call the 24-hour Compliance Hotline at 800.560.7013.

By mail, fax or email

  1. Download, complete and mail the Fraud, Waste & Abuse Report form (PDF)
  2. Send the form to:
    Priority Health, MS 3175
    1231 East Beltline NE
    Grand Rapids, MI 49525-4501
    OR
    Fax it to "Fraud & Abuse Program" at 616.942.7916
    OR
    Email it to SIU@priorityhealth.com

How to notify the Medicaid program

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 MDHHS OIG toll-free at 855.MI-Fraud (855.643.7283). Office hours are Monday through Friday, 8:00 a.m. to 5:00 p.m. Voicemail is available for after hours.
  • Use the online complaint form at michigan.gov/fraud.
  • Write to:
    Office of the Inspector General
    PO Box 30062
    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 (OIG) directly. You do not have to give your name. You may remain anonymous.

How to notify the Federal Employees Health Benefits (FEHB) program

If you suspect someone of committing fraud or abuse call Priority Health at 616.942.1221 or 800.446.5674. If Priority Health does not resolve the issue:

No. Federal regulations do not allow us give out status reports or any information about how we are handling a complaint to anyone, not even the person who made the complaint. Please know that we take the information you provide to us seriously and we take action according to our guidelines and legal requirements.

No, there are no rewards for fraud and abuse information.