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Report Suspected Health Care Fraud Form

Please complete this form if you believe that health care fraud and/or abuse may have involved you, a family member or a coworker. Any individual, entity or group that is employed by or provides a service on behalf of Highmark (including employees, members, professional providers, employees of a provider, facility, pharmacy or billing company) may be the subject of the complaint.

This form will be forwarded to the Financial Investigations and Provider Review (FIPR) department for review and evaluation. You will receive a response to your complaint unless you chose to remain anonymous.

Note: To ensure your privacy, all information will be sent via a secure connection. Due to the nature of these investigations, every effort will be made to keep information confidential.

Fields marked with an asterisk (*) are required.

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Do you wish to remain anonymous?

COMPLAINT AGAINST:

  • Provider
  • Member
  • Employee
  • Group
  • Facility
  • Pharmacy
  • Supplier
  • Other
  • AL
  • AK
  • AR
  • AZ
  • CA
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  • CT
  • DE
  • FL
  • GA
  • HI
  • IA
  • ID
  • IL
  • IN
  • KS
  • KY
  • LA
  • MA
  • MD
  • ME
  • MI
  • MN
  • MO
  • MS
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  • NC
  • ND
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  • NH
  • NJ
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  • NV
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  • OR
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  • TN
  • TX
  • UT
  • VA
  • VT
  • WA
  • WI
  • WV
  • WY