Our success is no accident; for more than three decades it has grown from the dedicated services of our associates, subcontractors, providers, and other business partners. Learn more about the people and processes that help us deliver quality health care solutions for those most in need.
With more than 35 years of experience, we have a rich history of providing mission- and outcomes-based care throughout the country. Download our Corporate Fact Sheet (PDF) for a snapshot of who we are, the solutions we offer, and the communities we serve. You can also explore our mission and vision.
Our Corporate Compliance program is based on a simple, straightforward premise — we are all responsible for “Doing the Right Thing in the Right Way.” This philosophy is deeply rooted in our mission, vision, and values. It is also reflected in our corporate culture, and the Code of Conduct and Ethics (PDF) to which we hold all of our associates accountable.
As a company, we maintain ongoing compliance with all of the federal and state regulations that apply to our operations, as well as the contractual requirements set by our regulatory partners.
To do so, we hold ourselves to the highest standards of ethics and integrity in everything that we do. Our Corporate Compliance program supports this commitment by promoting a culture of ethical behavior, accountability, and transparency.
We designed the program to not only meet, but to exceed the standards the federal government puts in place. Learn more by reading the Corporate Compliance Program description (PDF).
Fraud, waste, and abuse
The Department of Justice estimates that health care fraud costs the United States billions of dollars per year1. Our enterprise-wide Program Integrity department has a proven record of preventing, detecting, investigating, and mitigating fraud, waste, and abuse (FWA).
Its cross-functional teams monitor the claims activities of members and providers, and help to ensure the accuracy, completeness, and truthfulness of all claims and payment data. The department’s key priorities include:
- Educating key stakeholders, such as providers, on how to identify potential FWA and report it.
- Preventing FWA through the use of both prepayment and post-payment tools, including data mining.
- Providing multiple avenues for reporting suspected FWA, including a dedicated, toll-free hotline and an online reporting tool.
- Conducting investigations of suspected FWA with a dedicated Special Investigations Unit and referring cases as appropriate to law enforcement.
- Consumer Info & Action. National Health Care Anti-Fraud Association (NHCAA). https://www.nhcaa.org/resources/health-care-anti-fraud-resources/consumer-info-action.aspx
- S. Galea, M. Tracy, K.J. Hoggatt, C. Dimaggio, A. Karpati, "Estimated deaths attributable to social factors in the United States," American Journal of Public Health 101 (2011): 1456 – 65