Help reduce health care fraud and abuse. Here are a few examples of fraud and abuse:
"Fraud is when a person or provider knowingly makes or permits another person or provider to make a false statement in order to get services or items or receive a payment the provider or person does not have a right to receive. Examples of fraud include providers billing for services not rendered, or members submitting false or misleading information on a membership application form, making a false request for reimbursement, failing to notify Tufts Health Plan of changes (such as residency) that affect the member's eligibility or lending their Tufts Health Together member ID card to another person so s/he can get health care or pharmacy Service."
"Abuse is when a person or provider acts in a way that results in unnecessary healthcare costs. Abuse could include a provider rendering a medically unnecessary service, or billing in a way that make a service more costly than necessary.”
To report potential health care fraud and abuse, or if you have questions, please call us at 888-257-1985 (TTY: 711), Monday through Friday, 8 a.m. to 5 p.m., or email [email protected]. We don’t need your name or member information. You can also call our confidential hotline anytime at 877-824-7123 or send an anonymous letter to us at:
Tufts Health Plan
Attn: Fraud and Abuse
P.O. Box 524
Canton, MA 02021-1166