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  • Anti-Fraud and Abuse Information for Providers

    TakeCare has created an Anti-Fraud Hotline to specifically address health care fraud, a national problem, prevalent in federal and state (and territories) as well as private insurance programs. Health care fraud occurs when a person or business intentionally misrepresents facts to receive reimbursement for health care services or supplies. Health care fraud is estimated to cost billions of dollars each year.*

    If you suspect fraudulent actions and abuse within your plan or our network, please call (671) 649-5484 or email

    TakeCare has invested in programs to address healthcare fraud.

    In order to maintain the affordability of health care, it is important that all of our providers take the following precautionary steps against fraud and abuse. According to information from NHCAA (National Health Care Anti-Fraud Association), the most common types of fraud committed by providers are:

    It is not uncommon to see schemes in which amounts have ranged from a few hundred thousand dollars to several million dollars in a relatively short period of time, such as two to four years, before detection.

    TakeCare will not tolerate health care fraud or abuse in any of its relationships with either internal or external customers. TakeCare has implemented a comprehensive program to identify, resolve, report, and when appropriate refer for prosecution, situations in which suspected fraud or abuse occurs.

    *Reference: U.S. Department of Health & Human Services,

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