What if a provider appears to be charging a client extra?

If a Medicaid or Medicare/Medicaid client is turning in medical expense charges that appear to be covered, or the client is being charged the difference between the Medicaid or Medicare rate, you may need to refer the situation for an investigation.

Nursing facility, assistance living, group homes or adult family homes contact: Residential Care Services (RCS) complaint email box Complaint Resolution Unit (DSHS/RCS) .

All other Medicaid providers contact the Health Care Authority . Include your name, phone number, client and provider information and what the issue is.

Refer complaints regarding Medicare claims to 1-800-Medicare

If provider fraud is suspected, follow the procedures in HCS MB H13-011 issued 3/5/2013: procedures for report suspected fraud.