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Fraud, Waste and Abuse

Umpqua Health wants to make sure you get the care you need — and that no one takes advantage of the system. When people lie or misuse services, it’s called fraud, waste, or abuse, and it can hurt everyone.

What is Fraud, Waste, and Abuse?

We all have a role in helping prevent it.

Fraud is when someone lies to get money or health services they shouldn’t get.

  • Example: A doctor bills for a service you didn’t get.
  • Example: Someone uses your health ID card to get care that’s not for them.

Waste is when health care services are used the wrong way.

  • Example: Going to the emergency room for a sore throat instead of seeing your regular doctor.
  • Example: Getting tests you don’t need.

Abuse is when people use the system in a way that isn’t right, but not always on purpose.

  • Example: A clinic charges more than it should for services.
  • Example: A provider keeps giving a medicine that isn’t helping.

How Does This Affect You?

When people commit fraud or waste money, it takes resources away from people who really need help. It can also make health care cost more for everyone.

What Should I Watch For?

Look out for:

  • Bills for services you didn’t get
  • Someone using your health ID card
  • A provider offering cash or gifts for using their services
  • Doctors pushing services you don’t need

How to Report It

If something doesn’t seem right, tell us! You can report it anonymously — that means you don’t have to give your name.

We will never punish anyone for reporting something in good faith.

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We’re Here to Help

Stopping fraud, waste, and abuse helps everyone get the care they deserve. If you have questions or need help understanding your health benefits, contact us.

Together, we can protect your care.