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.
How to notify Priority Health of suspected fraud, waste or abuse
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
- Download, complete and mail the Fraud, Waste & Abuse Report form (PDF)
- Send the form to:
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.
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.
Department of Health and Human Services
Office of the Inspector General
P.O. Box 23489
Washington, DC 20026
How to notify the Federal Employees Health Benefits (FEHB) program
United States Office of Personnel Management
Office of the Inspector General Fraud Hotline
1900 E Street NW, Room 6400
Washington, DC 20415-1100
After you make a report
Q: Can I find out what happens after I make a fraud and abuse report?
A: 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.
Q: Is there a reward if I give information that identifies fraud and abuse?
A: No, there are no rewards for fraud and abuse information.