About Us



Benefits with the right focus!


Advantica has provided service over and above to our clients.  They help to ensure smooth renewals on our growing number of groups.  In addition, if all of my account reps were on top of renewal like Advantica’s, my job would be a lot easier!

- Broker

Fraud, Waste & Abuse

At Advantica, we have a zero-tolerance policy of Fraud, Waste and Abuse (FWA), and everyone is responsible to make a difference. The FWA program is build around protecting our beneficiaries and we believe this "member centric" vision is paramount to our overall mission of helping and protecting people.

With national health care expenditures of $2.6 trillion and rising each year, comprising of approximately 17.9% of our nation's Gross Domestic Product (GDP), it is imperative we curb the estimated 3% to 10% of FWA that plagues our health care system. As components, both the Medicare program, at a $525 billion spend in 2010, and the Medicaid program, at a $401 billion spend in the same year, are unable to withstand the burden of unnecessary expenditure. Advantica is honored to serve our members, providers employer group and health plan partners, and we understand how vital our role is in making an impact, and preserving the integrity of our health care system.

Reporting Health Care Fraud, Waste & Abuse

If you have a reason to believe Fraud, Waste or Abuse (FWA) has been committed, please contact us immediately and together we can make a difference. You can report information anonymously and confidentially 24 hours a day, 7 days a week. Contact options are listed below:

  • Via phone at 800-392-1167 ext. 2787
  • Via mail at:
    Advantica
    Attention: Fraud, Waste & Abuse Department
    12399 Gravois Road
    St. Louis, MO 63127
     
  • You may also report to the HHS-OIG via their Fraud Hotline: (800) HHS-TIPS (800-447-8477) / TTY: 800-377-4950
  • Or via mail at:
    U.S. Department of Health and Human Services
    Officer of Inspector General
    ATTN: OIG HOTLINE OPERATIONS
    P.O. Box 23489
    Washington, DC 20026

Whistleblower Protection: The Civil False Claims Act also provides protection for employees from retaliation. An employee who is discharged, demoted, suspended, threatened, harassed, or discriminated against in terms and condition of employment because of lawful acts conducted in furtherance of an action under the FCA may bring an action in federal district court seeking reinstatement, two time the amount of back pay plus interest, and other enumerated costs.

Helpful Fraud, Waste & Abuse Resources: