Report Suspicious activity to Mildura Health Fund

Report suspicious activity to Mildura Health Fund

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First Name

Last Name

Phone Number

Email Address *

Who did the suspicious activity involve?

Member Fraud

Member Name

Member Number (if known)

Member Date of Birth (if known)

Member Address (if known)

Street address

City

State

Postcode

Provider Fraud

Provider Name

Provider Number (if known)

Modality

Business Name

Provider Address (if known)

Street address

City

State

Postcode

Details of activity

What do you believe happened?

Where did it happen?

When did it happen?