WHAT TO REPORT

Fraud, Waste or Abuse                                                                                                       HIPAA Privacy or Security violations                                                               Violations of law or company policy

Unethical behavior or misconduct                                                                                  Discrimination                                                                                                       Harassment

Misuse or theft of company property                                                                            Workplace violence or retaliation                                                                     Substance abuse

Unfair labor practices                                                                                                         Identity theft and security of personal information                                     Conflicts of interest

Examples:

• Provider billing for appointments the patient failed to keep                               • Charging excessively for services or supplies
• Provider billing for services not furnished                                                               • Using someone else’s coverage or insurance card

Al though healthcare fraud is committed by a very small minority within the healthcare system, no one can assume it won’t happen to them. We encourage you to take these steps to avoid becoming a victim of healthcare fraud:

After care, review your statement to verify accuracy.                                                                   • Report instances where co-payments or deductibles are waived.
• Ask your doctor to explain the reason for services.                                                                       • Don’t give your insurance number to marketers or solicitors.
• Report any discrepancies to your health insurance plan or payer.                                             • Safeguard your insurance member ID card.
• Beware of “free” medical services, as illicit entities use this lure to obtain information.       • Never sign a blank insurance form.

HOW TO REPORT

Internal Compliance Reporting Options:                                                                                               Federal Government Reporting Options:
Email: compliance@advantagedental.com                                                                                                                                        Office of the Inspector General (Fraud, Waste or Abuse concerns only)
Compliance Alert Line 1-866-654-3433                                                                                                                                            1-800-HHS-TIPS (1-800-447-8477)
(available 24 hours a day – anonymous option)
Mail (anonymous option): Compliance Officer - CONFIDENTIAL                                                                                                U.S. Department of HHS Office of Inspector General
                                                 14201 NE 20th Ave B200 Vancouver, WA 98686                                                                         Attn: OIG Hotline Operations
                                                                                                                                                                                                                       PO Box 23489, Washington, DC 20026

State of Oregon Fraud Reporting Options:                                                           Department of Health and Human Services (HIPAA concerns only)                        Calling, 1-888-FRAUD01 (1-888-372-8301) Monday through Friday 8am to 5pm,                                                Email: OCRCompliant@hhs.gov
              or Report fraud online, or                                                                                                                                            Centralized Case Management Operations U.S. Department of HHS                                   
Fax your written complaint to ATTN: HOTLINE at 503-373-1525                                                                                 
200 Independence Avenue, S.W.
You may also mail a written complaint:                                                                                                                                                Room 509F HHH Bldg.
                     For client fraud - Investigations Unit, PO BOX 14150, Salem, OR 97309                                                               Washington, D.C. 20201
                     For provider fraud - DHS Provider Audit Unit, 3406 Cherry Ave NE, 2nd Floor, 
                                                                                                          Salem, OR 97303

No person is permitted to engage in retaliation, retribution, intimidation or any form of harassment against another person for reporting compliance-related issues in "good faith".

Any retribution, retaliation, intimidation or harassment is met with disciplinary action.

Compliance Alert Line: 1-866-654-3433