SFHP’s Health Care Fraud Awareness Program finds, prevents, and fights health care fraud, waste, and abuse (FWA). FWA leads to higher health care costs for everyone, less benefits for members, and worse health care quality. Sometimes, FWA can even hurt people’s health. People may get unneeded medications or services.

Be careful if you get suspicious phone calls.

Someone may say they are from San Francisco Health Plan (SFHP) and ask for your Social Security number, your SFHP ID, or other personal information. These calls are often scams to steal your identity or money.

What To Do During a Suspicious Call

  • HANG UP Do not press numbers or answer any questions. Report the call right away.
  • DO NOT SHARE YOUR INFORMATION Never give out your Social Security number, health plan ID, bank details, or passwords.
  • BE SKEPTICAL OF OFFERS Real health plans will not pressure you to sign up right away or offer “free” gifts for your information.
  • ASK FOR A CALL-BACK NUMBER ffer to call them back later.

Red Flags for Fraud

  • The caller says they are from the government (Medicare or Medicaid).
  • There is pressure to replace or “verify” your health plan card.
  • Someone asks for personal or financial information during an unexpected call.
  • There are promises of “free” benefits, services, or discounts.

Reporting suspected fraud helps protect your benefits and keeps our community safe.

How to Report Suspected Fraud, Waste, or Abuse

If you suspect FWA, report it right away:

San Francisco Health Plan (SFHP)

California Department of Health Care Services (DHCS)

More Help from SFHP

  • Customer Service: If you need help or have questions, call SFHP Customer Service at 1(415) 547-7800, 1(800) 288-5555 (toll-free), or 711 (TTY), Monday–Friday, 8:00am–5:00pm.
  • Interpreter Services: You can get an interpreter in-person or by phone for your health visits. When you make an appointment, ask for an interpreter at the same time.
  • Need a Ride? SFHP can help you get transportation to any medical appointment covered by Medi-Cal. Ask your provider or call Customer Service.
  • Interested in Medi-Cal Benefits? See if you or your family can get Medi-Cal through SFHP.

Learn more about your covered Medi-Cal benefits and services.

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