Fraud, Waste, & Abuse
Banner – University Care Advantage (B – UCA) is committed to preventing Fraud, Waste, and Abuse (FWA). If you suspect a B – UCA provider or member of fraud, waste or abuse - please contact B – UCA.
Fraud, Waste, and Abuse Defined
Fraud is purposely giving wrong or misleading information in order to receive a benefit or some type of service.
Waste is over-using services or misusing resources or practices.
Abuse of the Program is provider practices or member practices that result in an unnecessary cost to the Medicare program.
Unfortunately, Fraud, Waste, and Abuse are not as uncommon as you would think. Please see some of the most common examples.
Examples of Fraud and Abuse
Member Fraud, Waste, and Abuse include, but are not limited to:
- Lending or selling your Medicaid or Medicare card to anyone.
- Using someone else's Medicare card to obtain services.
- Changing prescriptions written by any B – UCA provider.
- Failing to report another insurance that you have.
- Giving incorrect information on your Medicare application.
- Providing false materials or documents.
- Leaving out important information.
Provider Fraud, Waste, and Abuse include but are not limited to:
- Use of the Medicare system by someone who is unqualified, unlicensed, or has lost their license.
- Providing unnecessary medical services leading to unnecessary costs to the program.
- Ordering tests, lab work, or x-rays that aren't necessary.
- 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.
- Charging for medical services not provided.
- Billing for services under a member who is not their member.
How to Report Fraud, Waste, and Abuse
Anyone can report fraud - there are no restrictions. Fraud, Waste, and Abuse hurts everyone. If you suspect a possible case, please report it right away.
If you suspect a provider or member of fraud, waste, and abuse - please contact B – UCA using any of the following methods:
Customer Care Center: (877) 874-3930; TTY users should dial 711
Confidential and Anonymous Compliance (ComplyLine) Hotline: (888) 747-7989; 24 hours a day/7 days a week
Banner – University Care Advantage
2701 E. Elvira Road
Tucson, AZ 85756
Compliance Department: (520) 874-7072