Fraud, Waste, and Abuse

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Banner Health Plans (BHP) is committed to preventing Fraud, Waste, and Abuse (FWA).

If you suspect a provider or member of fraud and abuse, please contact us at any of the following methods:

Phone: BHP Provider Experience Center
     Banner – University Family Care/ACC: 800-582-8686, TTY 711
     Banner – University Family Care/ALTCS: 833-318‐4146, TTY 711
            Banner Medicare Advantage Dual: 877-874‐3930, TTY 711

Confidential and Anonymous Compliance (ComplyLine) Hotline: 888-747-7989; 24 hours a day / 7 days a week.

Mail: Banner Plans and Networks
 Compliance Department
         5255 E Williams Circle, Ste 2050
  Tucson, AZ 85711

Fax: 520-874-7072

Email: [email protected]

You are also required to report directly to AHCCCS, Office of the Inspector General at: 

Provider Fraud: 602-417-4045 or 888-487-6686

Member Fraud: 602-417-4793 or 888-487-6686

Website: www.azahcccs.gov 

Mail: Inspector General
 801 E. Jefferson Street
         Phoenix, AZ 85034

Examples of Fraud, Waste, and Abuse

Member Fraud, Waste, and Abuse include, but are not limited to:

  • Lending or selling your AHCCCS Identification Card to anyone.
  • Using someone else's AHCCCS card to obtain services.
  • Changing prescriptions written by any B – UFC/ACC provider.
  • Not stating true income or living arrangements.
  • Providing false materials or documents.
  • Leaving out important information.
  • Failing to report another insurance that you have.
  • Continuing to use AHCCCS for services when you move out of the state or out of the country.

Provider Fraud, Waste, and Abuse include, but are not limited to:

  • Ordering tests, lab work, or x-rays that aren't needed.
  • Charging for medical services not provided.
  • 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.
  • Billing for services under a member who is not their member.
  • Providing unnecessary medical services leading to unnecessary costs to the program.
  • Use of the Medicaid system by someone who is unqualified, unlicensed, or has lost their license.