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Fraud, Waste & Abuse Resources

What you should know about fraud, waste & abuse

Protecting our members and their investment in our products is our highest priority. Sidecar Health maintains a fraud program intended to proactively prevent and detect fraudulent activity. If you identify or have knowledge of, any suspicious or potentially fraudulent activity being conducted by a provider, employee, or member, please report it. Additionally, if you are a current member, you should report suspicious or potentially fraudulent activity occurring within your account as soon as you discover it.

What is considered fraud, waste, or abuse?

Fraud is defined as the wrongful or criminal deception intended to result in financial or personal gain. Fraud includes false representation of fact, making false statements, or the concealment of information. 

Waste is defined as the thoughtless or careless expenditure, mismanagement, or abuse of resources to the detriment (or potential detriment) of the U.S. government or us, depending on the type of policy affected. Waste also includes incurring unnecessary costs resulting from inefficient or ineffective practices, systems, or controls.

Abuse is defined as excessive or improper use of a thing, or to use something in a manner contrary to the natural or legal rules for its use. Abuse can occur in financial or non-financial settings.

How do I notify Sidecar Health of suspected fraud, waste or abuse?

If you suspect an incident of fraud, waste or abuse, you have several ways to report it. Remember, you will always have the option to remain anonymous via our Online Form or Hotline number.