The reporting and investigation of compliance, privacy, or fraud incidents play a key part in creating a culture of honest and ethical behavior and conduct. Additionally, management of compliance, privacy, or fraud issues is an essential tool to improve our services. It also enables the organization to take appropriate actions to mitigate risks from happening again.
You can help to prevent fraud by asking for picture identification in addition to checking member ID cards or numbers. This will prevent non-members from using stolen or lost member insurance ID cards.
Anyone who becomes aware of a compliance, privacy, or fraud incident, whether it has occurred or is about to occur, should report it.
To report a compliance, privacy, or fraud incident:
- Call the anonymous Hotline: 1-866-477-4848.
- To report actual or suspected non-compliance, contact Compliance@jeffersonhealthplans.com.
- To report actual or suspected privacy or security concerns, contact PrivacyOfficial@jeffersonhealthplans.com.
- To report actual or suspected fraud, waste and abuse (FWA) concerns, contact SIUtips@jeffersonhealthplans.com.
Complete and submit allegations related to Compliance, Privacy or FWA anonymously online at jeffersonhealthplans.ethicspoint.com.