Compliance Department

Compliance Department

The goal of the Compliance Department is to prevent, detect and respond to issues of non-compliance at Passport Advantage (HMO-SNP) by promoting a values-based environment, conducting training, and encouraging an open dialogue on ethical issues and business practices

Through its Compliance Program, Passport Advantage demonstrates its commitment to the highest standards of ethics and compliance with all applicable state and federal laws, contractual obligations, rules and policies.
Complaince Web

Contact:
David Henley, VP & Chief Compliance Officer
Tracy Bertram, Director, Compliance
Tonya Appleby, Manager, Legal Counsel
LaRhanda Trammell,  Associate Director, Program Integrity

Passport Advantage
Compliance Department
5100 Commerce Crossings Drive
Louisville, KY 40229

Phone: (502) 585-8439
Email: PADCompliance@PassportHealthPlan.com

Report suspected compliance violations:
Hotline:  1-855-512-8500
Email:    PassportListens@getintouch.com

Contact the Hotline, if you have concerns about:
– Fraud, waste, and abuse
– Violations of the Passport Code of Conduct and Ethics
– How we conduct business

The Notice of Privacy Policy describes how medical information about you may be used and disclosed and how you can get access to this information.

Fraud, Waste, and Abuse

Passport Advantage (HMO-SNP) is committed to maintaining program integrity through the promotion of ethical business conduct and the prevention and detection of fraud, waste, and abuse. Passport Advantage’s program integrity functions are handled by the Program Integrity Unit in accordance with the Program Integrity Plan.

The Program Integrity Unit is responsible for:

  • Identifying and preventing provider and member fraud, waste, and abuse;
  • Investigating and tracking allegations of fraud, waste, and abuse by members, providers, and other sources; and
  • Identifying and addressing vulnerabilities in Passport’s program and taking appropriate action, such as recoupment of overpayments, changes to policy, dispute resolution meetings, and appeals.

Examples of Fraud, Waste, and Abuse

  • Member card sharing
  • Providers billing for services not performed
  • Providers billing a higher level of service than performed
  • Unbundling services

How you can help
If you suspect fraud, waste, or abuse, please report it.  You can report suspicious activity anonymously by calling Passport Advantage’s Hotline at 1-855-512-8500.

If you do not wish to remain anonymous, you may call Passport Advantage at (502) 585-8439 and ask to speak to a Program Integrity Auditor.  Please provide as many details as possible so we can fully investigate.  Please give the investigator your name and contact information so we can contact you if we need more information.

Contact Us

Passport Advantage (HMO-SNP)
Compliance Department
5100 Commerce Crossings Drive
Louisville, KY 40229
Phone: (502) 585-8439
Email: PADCompliance@PassportHealthPlan.com

Report suspected compliance violations anonymously:
Hotline:  1-855-512-8500
Email:    PassportListens@getintouch.com

Subrogation/Lien Request
Conduent Payment Integrity Solutions handles subrogation matters on behalf of Passport Advantage.  If you are an attorney representing a member of Passport in a case in which Passport Advantage may have a subrogation or reimbursement interest, please fax a letter of representation and a signed Passport Advantage Authorization of Release of Medical Records to Conduent at the number listed below.

Conduent Payment Integrity Solutions
Fax:      (847) 839 – 7207
Phone:  (800) 442 – 2911

Hours:
Monday – Thursday:   8:00 a.m. – 9:00 p.m. EST
Friday:  8:00 a.m. – 8:00 p.m. EST
Saturday: 9:00 a.m. – 5:30 p.m. EST

Request for access to open records should be addressed to:

Passport Health Plan
c/o Custodian of Records, VP & Chief Compliance Officer
5100 Commerce Crossings Drive
Louisville, KY  40229

Compliance Logo

 

 

Last Modified: May 10, 2017