Health care fraud is theft by deception. It's a serious concern for the entire health care industry. According to estimates from the National Health Care Anti-Fraud Association (an industry trade group), 3-10% of what Americans spend on health care is lost to fraud every year — that’s between $30 billion and $140 billion a year.
What we’re doing about it
We investigate fraud through our Special Investigations Unit (SIU). This group works aggressively to address issues and concerns about fraud and abuse. The SIU’s mission is to prevent, detect, investigate, and report fraud. When appropriate, they also recover money lost to health care fraud and abuse. The SIU works with members and their doctors and clinics to address fraud and abuse situations.
How you can help
Always check your Explanation of Benefits (EOB) statement to make sure the charges from your doctor are correct. And, be aware of the types of fraud listed below.
Common examples of fraud:
- Asking health insurance companies to pay for care that was not given
- Providing health care that’s not needed and collecting money for it
- Stating that a treatment is necessary when it’s not
- Making false changes to claims
- Adding someone to your health care plan who is not eligible
- Lending your ID card to family or friends
Contact us
If you suspect fraud, please call us at 1-800-382-2000, ext. 28363, submit a report online, or email reportfraud@bluecrossmn.com. You do not have to give your name. If you are calling after hours, please leave a message.
You can also mail or fax:
Blue Cross and Blue Shield of Minnesota
Special Investigations Unit
P.O. Box 64560
St. Paul, MN 55164-0560
Fax: (651) 662-1099