Report Fraud, Waste, and Abuse

You play a vital role in protecting the integrity of the Health Insurance Marketplace® program in South Carolina. To prevent and detect fraud, waste, and abuse, First Choice Next SM, a product of Select Health of South Carolina, Inc., works with the South Carolina Department of Insurance, members, providers, and law enforcement agencies.

Examples of fraud, waste, and abuse include:

  • Getting a bill or an explanation of benefits (EOB) for health care services you never received.
  • There being a lack of information in a provider’s health record about you to support services billed.
  • Loaning your health insurance membership card to others for the purpose of receiving health care services, supplies, or prescription drugs.
  • Providing false or misleading health care information that affect payment for services.

You can report suspected fraud and abuse in any of the following ways:

  • Call the Fraud Tip Line at 1-866-833-9718 or email FraudTip@amerihealthcaritas.com.
  • Write to First Choice Next’s Special Investigations Unit at P.O. Box 7318 London, KY 40742.
  • Contact the South Carolina Department of Insurance, Fraud Investigation Unit:

Below are examples of information that will assist with the investigation:

  • Contact information (e.g., name of individual making the allegation, address, phone number)
  • Description of the alleged fraudulent or abusive activities
  • Timeframe of the alleged activities
  • Name and identification number of the suspected individual
  • Source of the complaint, including the type of item or service involved in the allegation
  • Approximate dollar amounts involved, if known
  • Place of service
Members