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Fraud increases the cost of health care for everyone including you in the form of increased premiums, copays and coinsurance. All allegations of healthcare fraud, abuse and/or waste will be properly investigated by AXA's Compliance Department and any applicable federal or state regulatory agency.
If you suspect that fraud, waste or abuse is being committed, please contact our fraud and abuse hotline at 1-800-793-6745 or write to:
AXA-Assistance USA, Compliance Officer
122 S. Michigan Avenue Suite 1100
Chicago, IL 60603
United States of America
All reports are confidential and will be investigated appropriately, including applicable referral to law enforcement and regulatory agencies. Please include as much detail as possible to ensure our ability to investigate each issue. Reports may be made anonymously.
Below are some resources that will help clarify terms and make it easier to recognize what we need your assistance with.
DEFINITIONS
Fraud: means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person. It includes any act that constitutes fraud under applicable Federal State Law.
Abuse: means provider practices that are inconsistent with sound fiscal, business, or medical practices, and result in an unnecessary cost, or in reimbursement for services that are not medically necessary or fail to meet professionally recognized standards for health care.
EXAMPLES OF FRAUD AND ABUSE
Falsifying claims
- Alteration of a Claim
- Incorrect Coding
- Double Billing
- False Data Submitted
Falsifying Services
- Billing for Services/Supplies Not Provided
- Misrepresentation of Services/Supplies
Administrative/Financial
- Kickbacks
- Falsifying Credentials
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