Report Fraud, Waste & Abuse
If you suspect fraud, waste, or abuse in the healthcare system, you can report it to Humana and we'll investigate. Your actions may help to improve the healthcare system and reduce costs for our members, customers, and the people we do business with.
What is Fraud, Waste, and Abuse?
Fraud is generally defined as making a false claim in an effort to receive payment. For example, fraud in the healthcare industry can involve:
- Billing for medical services that weren't ordered or provided
- Billing for durable medical equipment items that weren't ordered or provided
- Providing services or items a person doesn't need based on his or her medical history
- "Doctor shopping" – when a patient who may or may not have a legitimate physical ailment goes from doctor to doctor to obtain multiple prescriptions for narcotic painkillers
To protect yourself from fraud, thoroughly review your Explanation of Benefits (EOB) after you receive healthcare services. If you see something that doesn't look right, you should report the situation right away.
How to Report Fraud, Waste, and Abuse
To report suspected fraud, waste, or abuse, you can contact Humana in one of these ways:
- Phone: English 1-800-614-4126
- Fax: 1-920-339-3613
- E-mail: siureferrals@humana.com
- Mail: Humana, Special Investigation Unit, 1100 Employers Blvd., Green Bay, WI 54344
Another option is to download the Special Investigations Referral Form form, fill it out, and mail it to us.
- Special Investigations Referral Form
- (68 KB) Download PDF
- English
