Report Fraud and Abuse
Fraud and abuse are the number one threats to our healthcare system, costing Americans billions of dollars each year. Healthcare fraud is the intent to deceive a company into paying for services that either were not or should not have been provided. Those breaking the law could be physicians, patients, laboratories, hospitals, employees, vendors, or a billing service used by a provider.
File a Grievance
To report a concern regarding Western Health Advantage, our network providers, or if you are unhappy with the care or service you received, please contact Member Services. We will try to resolve any problem you might have over the phone. Member Services can also assist you with submitting a written grievance. You can also start the grievance process by filling out the secure online form.
Western Health Advantage respects your privacy and protects your electronic, written and oral health information throughout our organization. All staff must complete training on the legal and ethical obligations to protect the privacy of member information. Additionally, we limit physical access to the WHA facility and password protect our electronic databases and limit staff access to only the health information they need to do their job.
Western Health Advantage complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age or disability. Western Health Advantage provides free aids and services to people with disabilities to communicate effectively with us.
Western Health Advantage understands how important it is to be able to effectively communicate with your health plan or health care provider. Western Health Advantage provides free language services to people whose primary language is not English, such as qualified interpreters and information written in other languages.
Your use of this site is subject to the terms and conditions of this agreement. By accessing, using and/or viewing our site, you hereby agree to be bound by the terms of this agreement and you agree to the terms of WHA's internet privacy practices. If you do not agree to these terms and conditions, you must exit this site.
Code of Business Conduct
Western Health Advantage’s Code of Business Conduct helps guide all Associates in performing our business activities within ethical and legal standards. The Code ensures that we comply with ethical standards and applicable laws and regulations appropriate to our business. The Code is designed to promote the prevention, detection, and resolution of conduct that does not comply with company policies in addition to state and federal laws and regulations.
Last review date: March 11, 2021