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PM FORM 7.1.1 Suspected Fraud or Abuse Report Reported by: Individual Family member T/RSHA Provider DBMS FAR Other Your name and title: Your contact information: Do you request contact from the ADDS/DBMS
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How to fill out suspected fraud and abuse

How to fill out suspected fraud and abuse:
01
Gather all necessary documentation and evidence related to the suspected fraud or abuse. This may include financial records, transaction details, emails, or any other relevant information.
02
Clearly identify the individuals or entities involved in the suspected fraud or abuse. Provide their names, addresses, contact information, and any other identifying details you have.
03
Describe the specific acts or behaviors that you believe indicate fraud or abuse. Be as detailed as possible, including dates, locations, and any supporting evidence you have.
04
If applicable, provide any witnesses or third-party accounts of the suspected fraud or abuse. Include their contact information and any statements or evidence they may have.
05
Determine the impact or harm caused by the suspected fraud or abuse. Explain how it has affected you or any other parties involved and provide any supporting documentation or evidence.
06
Contact the appropriate authorities or organizations to report the suspected fraud or abuse. This may include law enforcement agencies, regulatory bodies, or internal compliance departments. Follow their instructions on how to submit your report.
Who needs suspected fraud and abuse:
01
Individuals who have witnessed or have information about suspected fraud or abuse.
02
Employees or stakeholders within organizations who suspect fraudulent or abusive activities occurring within their workplace.
03
Individuals or organizations who have been directly affected by fraud or abuse and want to report it for legal or financial reasons.
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What is suspected fraud and abuse?
Suspected fraud and abuse refers to any questionable or potentially illegal activities that are believed to be occurring within an organization or program.
Who is required to file suspected fraud and abuse?
Anyone who suspects fraud or abuse within an organization or program is required to file a report.
How to fill out suspected fraud and abuse?
To fill out a report of suspected fraud and abuse, individuals can typically do so through a hotline, online form, or by contacting the appropriate authorities.
What is the purpose of suspected fraud and abuse?
The purpose of reporting suspected fraud and abuse is to prevent further harm or loss to the organization or program, and to hold accountable those responsible for the misconduct.
What information must be reported on suspected fraud and abuse?
When filing a report of suspected fraud and abuse, individuals should include as much detail as possible, including names, dates, locations, and any evidence or documentation available.
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