Fraud, Waste and Abuse

Back To Compliance Program

To report fraud, waste or abuse allegations use the following:

Email: [email protected]
Secure Fax: 602-805-2830

Banner Plans & Networks (BPN) is committed to preventing Fraud, Waste and Abuse (FWA).

If you suspect a provider or member of fraud and abuse, please contact us at any of the following methods:

Phone: BPN Provider Experience Center
    Banner - University Family Care/ACC: 800-582-8686, TTY 711
    Banner - University Family Care/ALTCS: 833-318‐4146, TTY 711
            Banner Medicare Advantage Dual: 877-874‐3930, TTY 711

Confidential and Anonymous Compliance (ComplyLine) Hotline: 888-747-7989; 24 hours a day/7 days a week.

Mail: Banner Plans & Networks
 Compliance Department
         5255 E Williams Circle, Ste 2050
 Tucson, AZ 85711

Fax: 602-805-2830

Email: [email protected]

You are also required to report directly to AHCCCS, Office of the Inspector General at: 

Provider Fraud: 602-417-4045 or 888-487-6686

Member Fraud: 602-417-4793 or 888-487-6686

Website: www.azahcccs.gov 

Mail:

Inspector General
Arizona Health Care Cost Containment System
150 N. 18th Ave.
Phoenix, AZ 85007

Examples of Fraud, Waste and Abuse

Member Fraud, Waste and Abuse include, but are not limited to:

  • Lending or selling your AHCCCS Identification Card to anyone.
  • Using someone else's AHCCCS card to obtain services.
  • Changing prescriptions written by any B - UFC/ACC provider.
  • Not stating true income or living arrangements.
  • Providing false materials or documents.
  • Leaving out important information.
  • Failing to report another insurance that you have.
  • Continuing to use AHCCCS for services when you move out of the state or out of the country.

Provider Fraud, Waste and Abuse include, but are not limited to:

  • Ordering tests, lab work, or x-rays that aren't needed.
  • Charging for medical services not provided.
  • Billing multiple payers and receiving double payments.
  • Using billing codes that pay higher rates to get more money even though those services weren't provided.
  • Billing for services under a member who is not their member.
  • Providing unnecessary medical services leading to unnecessary costs to the program.
  • Use of the Medicaid system by someone who is unqualified, unlicensed, or has lost their license.