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Fraud Warning: Watch Out For Fake Medical Records Requests

Date: 04/30/24

Sunshine Health is warning providers to watch out for fake emails requesting member medical records from providers.

In a recent case, we discovered a fraudulent “Primary Care Provider Authorization Request” email seeking a member’s records. It appears similar to our Utilization Management requests.

Be warned: This email is not from Sunshine Health and providers should not respond to it.

A good way to determine if an email is fake to look at the email address that it wants you to respond to. In this case, the email asked providers to send medical records to a gmail.com domain. That email domain is not used by Centene, Sunshine Health or any of our health plans:

  • Ambetter (Marketplace)
  • Children’s Medical Services (CMS) Health Plan
  •  Sunshine Health (MMA), Child Welfare Specialty Plan (CWSP), Serious Mental Illness (SMI) and Long Term Care (LTC)
  • Wellcare, Wellcare by Allwell (Medicare)

We will never communicate with you, your staff and your practice via personal email domains such as aol.com, gmail.com, icloud.com, outlook.com, yahoo.com, etc.

If you have concerns about any Sunshine Health communications you receive, please reach out immediately to your Provider Engagement Administrator or call Sunshine Health Provider Services at 1-844-477-8313. Before you delete any fraudulent communications, please send us a copy so we can warn other providers.

Together, we can protect the private medical information of your patients, our members.

Questions?

If you have any questions, please call Sunshine Health Provider Services at 1-844-477-8313 or visit the Secure Provider Portal. Our Provider Engagement staff are also here to help answer questions. Visit the Find Your Administrator tool to confirm the individual supporting your specialty and region. We encourage you stay up to date on Sunshine Health provider notices by reviewing and bookmarking Provider News.

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