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 TDP 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 submission form, which can also be found in the Forms/Materials section.
• Submit written correspondence directly to:
  
        Special Investigations Unit(SIU)
        United Concordia
        4401 Deer Path Road, DP-4E
        Harrisburg, PA 17110
• 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