What is health care fraud? It's when a medical provider or plan member submits, or causes someone else to submit, false or misleading facts to determine the amount of health care benefits to be paid. And it’s a crime!

Common types of fraud include:

  • Medical identity theft;
  • Giving false statements on an application;
  • Submitting claims for services that were not performed;
  • Misrepresenting services that were provided; and
  • Providing medically unnecessary services.

Insurance fraud is a serious crime! Read your Explanation of Benefits (EOB) carefully. The EOB is your notice that QualChoice has paid a claim under your health care plan. Look for:

  • Incorrect dates of service;
  • Services that you did not receive;
  • Services from ancillary providers (labs, x-ray providers, etc.) that did not see or treat you.


If you suspect fraud:

Email: fraud@QualChoice.com

Call: 800.235.7111, ext. 6740, or

Write: P.O. Box 25610, Little Rock, AR 72221

All reports are private.