Fraud, Waste, and Abuse

Absolute Total Care wants to find and stop fraud, waste, and abuse. We want you to help us. We want our doctors to help us. Please tell us if you see something that you do not think is right.

What does this mean?

Fraud: Intentional deception or misrepresentation to obtain the money or property of a healthcare benefit program (by means of false or fraudulent pretenses, representations, or promises).

Waste: Using services or other practices that result in costs not needed.

Abuse: Getting money for items or services when there is no legal reason for that payment, but without knowing and/or intentional misrepresentation of facts to obtain payments.

Who should you contact about fraud, waste, and abuse?

  • Absolute Total Care: 1-855-735-4398. Hours are from 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. TTY users call 711.
  • South Carolina Department of Health and Human Services (SCDHHS) Program Integrity: 1-888-364-3224
  • Medicaid Fraud Control Unit: 1-888-662-4328
  • Medicare or Medicaid Fraud Hotline: 1-800-447-8477
  • South Carolina Office of Inspector General: 1-855-723-7283 (1-855-SC-Fraud)

To report any suspected areas of fraud or abuse to us please call Member Services at 1-855-735-4398. Hours are from 8 a.m. to 8 p.m., Monday through Friday.  After hours, on weekends and on federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. TTY users call 711.

All information will be kept private. Eliminating fraud and abuse will provide more time and money for your healthcare needs.

 

Last Updated: 09/30/2017
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