- To Report Fraud, Waste and Abuse
- Call ECHP's Hotline: 866 678-8355
24 Hr Nurse Advice Hotline (800) 581-9952
Code of Conduct
WellCare is firmly committed to creating and maintaining a culture that promotes and supports ethical business conduct. Our Code of Conduct demonstrates our unwavering commitment to conducting all aspects of our business with the highest level of integrity.
Fraud, Waste and Abuse: Detection, Prevention and Reporting
Preventing and correcting fraud, waste and abuse (FWA) in health care is essential to our success in the work we do. Fraud, waste and abuse can occur in many ways. Examples include:
- Altering an invoice or receipt to secure payment
- Billing for a more expensive service than provided
- Submitting a claim for medications or services not provided
- Falsifying a patient's diagnosis to justify an unnecessary medical procedure
- Misrepresenting a procedure to secure payment for a non-covered procedure
- Billing multiple times for the same service
- Using another's ID or insurance card without authorization
If you detect or suspect FWA, please report it immediately to our toll-free Fraud, Waste and Abuse ("Fraud") Hotline at 1-866-678-8355 (TTY 711).
Your report is confidential, and WellCare prohibits retaliation against anyone for reporting in good faith a possible violation of the Code, law, rule or regulation.
Our Compliance Department investigates reports and works with other departments in the company to ensure that all appropriate steps are taken to stop fraud, waste and abuse.
Fraud, Waste and Abuse: Training
Per Federal law, Easy Choice Health Plan requires its employees, as well as its First tier, downstream and related entities’ employees, who have involvement in the administration or delivery of Parts C and D benefits, to undergo FWA training within 90 days of initial hiring or contracting, and annually thereafter.
Citations: 42 C.F.R. §§ 422.503(b)(4)(vi)(C), 423.504(b)(4)(vi)(C)
Please note: First tier, downstream and related entities will need to provide attestations that FWA training has been completed for their respective organizations and be prepared to produce copies of training logs and other materials upon request.
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