Vantage is dedicated to improving healthcare. Vantage's efforts to detect and prevent insurance fraud, waste, and abuse ("FWA") are important in maintaining the level of service provided to our members.
FWA can cause premium increases, and even the reduction or termination of some benefits. We believe that early detection and proactive prevention of FWA, through Vantage's efforts and the efforts of our members and providers, will limit the negative impact of FWA on the healthcare system and those who access its services.
Vantage has developed a Fraud, Waste, and Abuse Program to serve as a guide to assist those associated with Vantage in preventing, detecting, investigating, and helping correct conduct which is considered to be fraudulent, wasteful, and/or abusive. This Program was submitted to the Louisiana Department of Insurance in March 2011 and is available for your review.
Fraud is an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to the person or others.
Examples of fraud:
Waste and Abuse can be viewed as spending that can be reduced without impacting the quality of care received by the member.
Examples of waste and abuse:
You can help! If you suspect fraud by a provider or member, please report it to Vantage for investigation. All correspondence is confidential.