Helpful Hints and Resources
Back to Stop Medi-Cal Fraud
Health care fraud can be confusing, and not every issue is fraud. These helpful hints and resources can guide you if you have questions or concerns.
Medi-Cal members
- Keep your Beneficiary Identification Card (BIC) secure. If it’s lost or stolen, contact your local county office immediately for a replacement.
- Report suspected misuse of your BIC. Fraud occurs if someone knowingly uses a card that isn’t theirs.
- Review your health care statements. If you see services you didn’t receive, report it.
- Protect your personal information. Never share your Social Security number or Medi-Cal details with anyone offering gifts or money.
Providers
- Maintain accurate records. Document all services provided and keep copies of authorizations.
- Know what is not fraud. Short visits or a difference of opinion on diagnosis are not fraudulent by themselves.
- Stay alert for pressure or offers. Decline any gifts or incentives tied to patient recruitment or billing.
Resources
For non-fraud issues, these official resources can assist:
- Medi-Cal Managed Care Help: (888) 452-8609 – Helps members resolve complaints with Medi-Cal health plans
- Provider Support: (800) 541-5555 – Assistance for billing, eligibility verification, and technical help to ensure providers can resolve issues and access program resources
- California Medical Board: (800) 430-4263 – Regulates and licenses physicians and surgeons
- Department of Consumer Affairs: (800) 952-5210 – Handles complaints about Physician Assistants
- California State Board of Pharmacy: (916) 574-7900 – For pharmacist misconduct or prescription errors
- California Board of Registered Nursing: For complaints about unsafe or unprofessional nursing care
Fraud, waste, and abuse threaten the integrity of Medi-Cal and take resources away from those who need care. DHCS is committed to accountability and transparency, but we can’t do it alone. Protecting Medi-Cal is a shared responsibility, and you play a critical role. If you suspect Medi-Cal fraud, report it immediately.
