United Concordia Dental

Special Investigations Unit Fraud Complaint

United Concordia Dental is committed to its members, the dental community, and customers not to ignore fraud.

Fraud Complaint

Reporting Fraud

Use this form if you suspect that fraudulent activity may have occurred.

Please provide as much information as possible pertaining to your complaint. Failure to provide sufficient information or documentation may prevent or delay the investigation of your complaint.
Your Full Name is required.
(optional)
Identification Number is required.
Email is required.
Confirm Email is required.
Must use a 10 digit number.
(optional)
Ext cannot exceed 5 characters.
Name of Dentist Office is required.
Must use a 10 digit number.
(optional)
Ext cannot exceed 5 characters.
Line 1 is required.
Line 2 cannot exceed 37 characters.
Dentist City is required.
Dentist State is required.
Dentist ZIP is required.
Describe the details including the date of the visit(s).
 of 5,000 characters
Fraud Complaint Details is required.
Submit

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United Concordia Dental complies with all applicable federal civil rights laws.

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