Practice caution with requests for patient information

Our Corporate and Financial Investigations Unit has been made aware of provider offices receiving fraudulent requests for patient information, provider NPI numbers and provider signatures. See below for some recent examples.

These requests, which may come to you by standard mail, email or fax, often include clues that indicate they are not legitimate. For example:

• The use of a generic “BlueCross BlueShield” logo that isn’t the official Blue Cross Blue Shield of Michigan, Blue Care Network or Blue Cross and Blue Shield Association logo.
• Obvious grammatical errors (wrong tense, misspelled words, random or inconsistent capitalization, etc.).
• Phone numbers that are answered using generic statements such as “Please hold while we connect you.”

Health care fraud is a serious crime that increases health care costs for everyone and can also present patient safety issues. To help protect you and your patients, Blue Cross recommends that you carefully verify every request you receive for patient information before sending a response.

Examples:
 

If you suspect a request may be fraudulent, don’t respond to it.

If you’re suspicious of a request that you receive, you can contact our Fraud Hotline at 1-844-STOP-FWA (1-844-786-7392) or send an email to StopFraud@bcbsm.com. We may ask you to share the request so we can check its legitimacy.

For more information, check out the Victimized Provider Project section** of the Centers for Medicare & Medicaid website. The Victimized Provider Project helps keep providers from being held liable for overpayment for claims paid that are the result of identity theft.

By working together, we can help eliminate fraud, an effort that will improve patient safety and reduce costs.

**Blue Cross Blue Shield of Michigan doesn’t own or control this website.