Report Fraud

Fraud, waste and abuse

CareSource has a program designed to handle cases of fraud, waste and abuse. Fraud can be committed by providers or members. Examples of provider fraud include doctors or other health care providers who:

  • Prescribe drugs, equipment or services that you feel are unnecessary
  • Schedule more frequent return visits than you feel are necessary
  • Bill for services not provided to your child

The following examples are considered member fraud. CareSource monitors these member activities:

  • Members who share their CareSource ID card with other people
  • Members who use CareSource to obtain controlled substances, medical equipment, or services that they do not need
  • Altering prescriptions

If you suspect fraud

If you think a doctor or a CareSource member is committing fraud or abuse, you should report it to us by:

  • Calling 1-866-415-0584 (TTY: 1-800-750-0750 or 711) and selecting the menu option for reporting fraud; or
  • Writing us a letter and sending to:
  • CareSource
    Attn: Special Investigations Unit
    P.O. Box 1940
    Dayton, OH 45401-1940

You do not have to give us your name when you write or call. There are other ways you may contact us that are not anonymous. If you are not concerned about giving your name, you may also use one of the following means to contact us:

Fraud Email: fraud@caresource.com

Fraud Fax: 1-800-418-0248

When you report suspected fraud and/or abuse, please give us detailed information that includes a clear description of what you believe has happened and the names and phone numbers of those involved, if you have them. If you choose not to leave your name, we will not be able to call you back for more information so leave as many details as possible. Your message will be kept confidential whenever possible.