CenCal Health would like to remind our Provider Partners to remain vigilant about cybersecurity and fraud, waste, and abuse (FWA). Criminals and threat actors often take advantage of busy operational periods and reduced staffing to launch phishing attacks and fraud attempts. Please keep the following guidance in mind:
Cybersecurity
- Watch for unexpected messages, urgent requests, or links/attachments from unknown senders. Exercise caution and proper judgement when opening attachments, clicking links, forwarding, or responding to emails from unknown or unexpected senders.
- Double-check any request for payments, password resets, or sensitive information, even if they appear to come from colleagues, managers, or provider partners.
- Check multi-factor authentication (MFA) requests and ensure the location is the same as where you are located.
- Lock your screen when away and ensure devices are not shared or left unattended.
- Do not leave laptops or cell phones in the passenger compartment of a vehicle. Always secure them in the trunk.
- If your office experience security incidents or breaches involving CenCal Health members, report it immediately to CenCal Health.
Fraud, Waste, or Abuse (FWA)
Please remain alert for potential FWA activities, which may increase during periods of high workload or staffing challenges, including:
- Unexpected deliveries: Receiving durable medical equipment or supplies that were not ordered or authorized.
- Member identification misuse: Members sharing insurance identification cards; always verify that the individual receiving services matches the member associated with the card.
- Improper billing practices: Billing for services not rendered, inflating services, or altering documentation to submit additional claims (e.g., billing on days the office is closed, misrepresenting non-urgent or unnecessary services as urgent care).
Report suspicious activity, incidents, and breaches to CenCal Health using one of the following methods:
- Phone: Anonymous Compliance Hotline: 866-775-3944
- Online https://cencalhealth.alertline.com/gcs/overview
- Email compliance@cencalhealth.org. Please send via secured email for reports containing PHI.
- Mail: 4050 Calle Real Santa Barbara, CA 93110
- Fax: 805-681-8279. Please send “ATTN: Compliance Department”
Thank you for protecting our shared members, keeping the data secure, and upholding the integrity of the health care system.