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Report 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, and it's one of the first lines of defense against health care fraud.

  • Read your EOBs carefully
  • The EOB includes a toll-free number to call if you have questions
  • Visit your regional contractor's website to view your EOBs, get your claims history and track TRICARE costs paid.

And remember, no one from TRICARE will ever contact you to recommend a particular product or medicine. If are ever contacted on the phone or via email, don't share any personal information and report the incident to your contractor immediately.

See the table below for details about how to report suspected fraud or abuse.

Medical

For all plans except TRICARE For Life and the US Family Health Plan, report fraud or abuse to your regional contractor:

TRICARE For Life:

US Family Health Plan:

  • Call 1-800-748-7347

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:

  • Report online
  • Stateside: 1-888-838-8737
  • Overseas: (AT&T USADirect Access Number) + 866-721-8737

Last Updated 12/17/2014