Program Integrity
Sentara Health Plans’ Program Integrity Unit (PIU) has a fiduciary responsibility to protect our beneficiaries and is crucial in maintaining the integrity of Sentara Health Plans. The Program Integrity Unit is a dedicated team that focuses on detecting, resolving, and preventing potential fraud, waste, and abuse (FWA) by analyzing claims data, monitoring trends, and conducting in-depth investigations to uncover suspicious activities and unusual patterns of potential abusive behavior. The Program Integrity Unit’s efforts not only help safeguard financial resources but also ensure that care and coverage remain accessible to those who truly need them.
The Program Integrity Unit has documented our efforts to detect, resolve, prevent, and report potential fraud, waste, and abuse by implementing an Anti-fraud Plan to ensure compliance with state and federal regulations.
Read more about Sentara Health’s Anti-Fraud Plan.
To report possible fraud, waste or abuse, please utilize the following options:
Hotline:
- (757) 687-6326 or (866) 826-5277
- Available 24 hours a day, 7 days a week. This is a voicemail service only; someone will contact you within 48 hours.
Email:
All referrals made to the Program Integrity Unit (PIU) may remain anonymous. Please be sure to leave your name and number if you wish to be contacted for follow up.