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Fraud or Abuse

What is fraud and abuse?

  • Fraud—when a person or organization deliberately deceives others to gain some sort of unauthorized benefit.
  • Abuse—when providers supply services or products that are medically unnecessary or that do not meet professional standards.

You're an important partner in the ongoing fight against fraud and abuse.

  • Your explanation of benefits (EOB) is a statement of services or supplies received
  • Its one of the first lines of defense against health care fraud
  • Each EOB includes a toll-free number to call if you have questions about any services 
  • Read your EOBs carefully and to visit your regional contractor's website to view your EOBs, get your claims history and track TRICARE costs paid.

Report Fraud or Abuse

Medical

Contact your regional contractor's fraud and abuse office:

Or submit a fraud report to the Defense Health Agency.

Pharmacy

Contact Express Scripts:

Active Duty Dental Program

Contact United Concordia:

United Concordia Companies, Inc.
Special Investigations Unit
4401 Deer Path Road, DP-4F
Harrisburg, PA 17110

TRICARE Dental Program

Contact MetLife:

MetLife Special Investigations Unit-TRICARE
5950 Airport Rd
Oriskany NY 13424

TRICARE Retiree Dental Progam

Contact Delta Dental:

  • Stateside: 1-888-838-8737
  • Overseas: (AT&T USADirect Access Number) + 866-721-8737
  • www.trdp.org

Last Updated 7/23/2014