How Can I Recognize and Report Health Care Fraud?
Health care fraud is a felony. It may be committed by Blue Cross members and health care professionals. The consequences of fraud include:
Sometimes fraud is easy to spot, like when someone steals your name and insurance information to get prescription drugs. Sometimes it’s not so easy, like when a doctor performs or orders unnecessary services to increase payments from the insurance company. Protect yourself and others by learning how to spot fraud.
If the date on your EOB is wrong, or you see a service listed that you didn’t get, this can indicate fraud. Consider reporting a suspicious EOB, because otherwise you could be paying for charges you shouldn’t have to pay.
Here are two tips to make this easier:
Loaning an insurance card or using an expired card to get medical care is fraud. So is keeping or putting someone on your contract who shouldn’t be there, like an ex-spouse.
Health care providers who offer free services or waive your copay might not be giving you a bargain. Instead, they could be charging the insurance company more for other services to make up the difference, or adding on services you didn’t receive.
Thanks to members reporting fraud, Blue Cross has recovered more than $400 million. Here’s how you can contact us to report suspected fraud. Remember, all information is confidential.
Fax to: 1-800-590-4616
Blue Cross Blue Shield of Michigan
Corporate and Financial Investigations
Department MC 1825
600 E. Lafayette
Detroit, MI 48226