ABOUT YOUR HEALTH is published as a community service for the friends and patrons of EL PASO HEALTH, 1145 Westmoreland Drive, El Paso, TX 79925, telephone 1-877-532-3778, website elpasohealth.com. Information in ABOUT YOUR HEALTH comes from a wide range of medical experts. If you have any concerns or questions about specific content that may affect your health, please contact your health-care provider. Models may be used in photos and illustrations. 2022 © Coffey Communications, Inc. All rights reserved. EPHM5762209-EPH-MBR-Winter 2023 Member Newsletter Member Services Department 1-877-532-3778 When someone does something wrong and knows it, it is fraud. When someone doesn’t follow the rules by mistake, it is abuse. When someone spends money or uses things without care, that can be waste. All three things are bad and can get people in a lot of trouble What’s new at El Paso Health? CASE MANAGEMENT FOR CHILDREN AND PREGNANT WOMEN (CPW) El Paso Health has a new program for Medicaid members of any age who have a high-risk pregnancy and for members with a health condition up to the age of 20. Ser vices include helping you with doctor visits or school issues. For more information, call 915-532-3778. If you see something, say something! WE NEED YOUR HELP TO STOP FRAUD, WASTE, AND ABUSE if caught. This is why it is so important to say something as soon as you see something suspicious. Here are some examples of fraud, waste, and abuse in health care. By members ■Someone lying in an application about where they live or how much money they have or make. ■Someone giving their Medicaid card to a friend or family member so they can pretend to be that person to go see the doctor. ■Someone using the emergency room for services that are not emergencies. If it is not an emergency, they should see their regular doctor in the doctor’s office. By doctors or medical companies ■A doctor ordering many tests or exams you don’t need. If you feel like you don’t need it, say something. ■A company billing for a fancy wheelchair, but giving a member a basic wheelchair. If you feel you should have gotten something better, say something! ■A doctor billing us for a visit that never happened or billing us for services that happened on a different day. If you see something, say something! Fraud, waste, and abuse should be reported: ■You may contact El Paso Health’s anonymous hotline for waste, abuse, and fraud: 1-866-356-8395. ■You may contact the Texas Office of Inspector General: https://oig.hhs.texas.gov/ report-fraud-waste-or-abuse. member news
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