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Email
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Employee
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Date Issue Identified
Date Issue Occurred
Incident Type
Corporate Integrity (Anonymous Report)
Appeals & Grievances
Billing/Finance
HIPAA/HITECH
Claim
Security
Doctor Shopping/Drug Seeking
False Information
Identity Theft
Inappropriate Billing
Known or Suspected Regulatory Shortfall
Mail/Materials/Fulfillment
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Member Eligibility
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Policy or Procedure
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Vendor Quality of Service
Product Type
Assure
Commercial
ETF
Family Savings Plan
HIX
Medicare
Self-Insured
Description of Issue
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