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Identify

 

Identify Healthcare Fraud & Abuse

 

Insurance fraud costs you money in the form of higher healthcare costs. In fact, losses to fraud account for an estimated 10% of what's spent on healthcare annually. At Blue Cross and Blue Shield of Alabama, our associates are dedicated to stopping fraud. However, we still need help from people like you.

 

Helping Blue Cross uncover fraud is easy. All you have to do is:

  • Know what to look for
  • Keep watch
  • Report suspected fraud and abuse

 

What to look for:

Common types of healthcare fraud include:

  • Filing false claims or billing services that were not performed - when policy holders or medical care providers submit claims or bill services to receive payment for services that weren't provided.
  • Including misleading information in an application for coverage - a person lies about a relationship to a contract holder or deliberately gives incorrect information to receive benefits not entitled to.
  • Using ID cards that belong to someone else - using another person's insurance ID card to receive or pay for services one isn't eligible for.

 

Keeping Watch:

  • Read any Explanation of Benefits (EOB) you receive carefully
  • Take note if you seem to be paying unusually high charges for regular services
  • Understand what services your benefits provide

 

Report Suspected Fraud and Abuse:

We need your help in identifying cases of fraud and abuse. After all, only you know the services you received. If you see something on an Explanation of Benefits (EOB) that doesn't look right or if it lists a service you don't think was performed, contact your doctor or healthcare provider to question it. If you still have questions or concerns after talking to your provider, complete the online form to report suspected fraud and abuse or call our fraud hotline at: 1-800 824-4391.

 

Medicare Site Stock ID

Blue Advantage is a PPO with a Medicare contract. Enrollment in Blue Advantage (PPO) depends on contract renewal. Blue Rx is PDP with a Medicare contract. Enrollment in BlueRx (PDP) depends on contract renewal. C Plus℠ is a Medicare Select Plan and is a private insurance plan regulated by the Alabama Department of Insurance. It is not connected with or endorsed by the U.S. government or the federal Medicare program.

Last Updated: 09/30/2024 20:56

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Y0106_MKT5WEB

© 2025 BlueCross BlueShield of Alabama is an independent licensee of the BlueCross BlueShield Association.

Third Party Website Disclaimer

You are about to leave Blue Cross and Blue Shield of Alabama's website and enter a website operated by Prime Therapeutics, LLC. Prime is our business associate and is an independent company that provides pharmacy benefit management services to Blue Cross health plans. Prime has agreed to follow Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information.

To continue to the Prime website, click "Accept." If you want to stay on the Blue Cross website, click "Cancel."

Third Party Website Disclaimer

This link takes you to another web site. Some areas of our site may provide links to other external sites that we don't own, control or influence. We reference sites that we think might be useful or of interest to you, but we are not responsible for the content or privacy practices used by other site owners. Information contained in the external sites is not endorsed by BCBSAL.

To continue, click "Accept". If you want to stay on the Blue Cross website, click "Cancel".

Third Party Website Disclaimer

You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website to learn more about our Dental Plans. The site is operated by Blue Cross and Blue Shield of Alabama and all Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information apply here as well.

To continue to our Commercial website, click "Accept." If you want to stay on the Blue Cross Medicare products website, click "Cancel".

Third Party Website Disclaimer

This link takes you to another web site. Some areas of our site may provide links to other external sites that we don't own, control or influence. We reference sites that we think might be useful or of interest to you, but we are not responsible for the content or privacy practices used by other site owners. Information contained in the external sites is not endorsed by BCBSAL.

To continue, click "Accept". If you want to stay on the Blue Cross website, click "Cancel".

Third Party Website Disclaimer

You are about to leave Blue Cross and Blue Shield of Alabama Medicare website to visit the UTIC Insurance Company website. The site is operated by UTIC Insurance Company and all of UTIC Insurance Company's privacy and security policies regarding the confidentiality and protection of your personal health information apply.

To continue, click "Accept." If you want to stay on the Blue Cross and Blue Shield of Alabama Medicare website, click "Cancel."

Third Party Website Disclaimer

You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website to visit one of our social media sites. Although content of our social media sites is maintained by Blue Cross, Blue Cross does not control the security and/or privacy practices of these external social media sites. Therefore, Blue Cross advises users of these sites against sharing any personal health information or any other information the user would otherwise not feel comfortable being made public. Blue Cross shall not be liable for privacy breaches, security incidents or similar events due to the use of social media sites.

To continue, click "Accept." If you want to stay on the Blue Cross and Blue Shield of Alabama Medicare website, click "Cancel."

Third Party Website Disclaimer

This link takes you to another web site. Some areas of our site may provide links to other external sites that we don't own, control or influence. We reference sites that we think might be useful or of interest to you, but we are not responsible of the content or privacy practices used by other site owners. Information contained in the external sites is not endorsed by BCBSAL.

To continue, click "Accept." If you want to stay on the Blue Cross Medicare products website, click "Cancel."

Third Party Website Disclaimer

You are leaving the Blue Cross and Blue Shield of Alabama Medicare products website to log into myBlueCross, Blue Cross and Blue Shield of Alabama's member website. myBlueCross is operated by Blue Cross and all privacy and security policies regarding the confidentiality and protection of your personal health information apply here as well.

To continue, click "Accept." If you want to stay on the Blue Cross Medicare products website, click "Cancel."

Third Party Website Disclaimer

You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website and go to AlabamaBlue.com. AlabamaBlue.com is operated by Blue Cross and Blue Shield of Alabama and all Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information apply here as well.

To continue, click "Accept." If you want to stay on the Blue Cross Medicare products website, click "Cancel."

Third Party Website Disclaimer

You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website to learn more about vision plans. The site is operated by Blue Cross and Blue Shield of Alabama and all Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information apply here as well.

To continue to our Commercial website, click "Accept." If you want to stay on the Blue Cross Medicare products website, click "Cancel".

Third Party Website Disclaimer

You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website and be taken to another website. The site is operated by Blue Cross and Blue Shield of Alabama and all Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information apply here as well.

To continue, click "Accept." If you want to stay on the Blue Cross' website, click "Cancel".


© 2025, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association.

C Plus Plan F Disclaimer

Per Federal Guidelines, you are eligible for Plan F only if you became eligible for Medicare prior to January 1, 2020.

By clicking "Accept", you are acknowledging that you are eligible for C Plus Plan F and would like to continue with the enrollment process. If you would like to go back to the C Plus Compare and Enroll page, click "Cancel".

Third Party Website Disclaimer

As a Patrius representative, I agree to the payment terms and conditions of Patrius Health and will not collect any checking account, debit card or credit card information on behalf of the consumer for the purchase of health or dental insurance.

To continue , please click "Accept."

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