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Health care fraud

Billions of dollars in health care fraud occur each year. The crime, which is predicted to become even more common in the future, includes everything from health care identity theft to billing for health care services that were never performed. Losses from health care fraud lead to increased health care costs, which can make care more expensive for all of us. National estimates project that billions of dollars are lost to health care fraud and abuse on an annual basis.

Examples of health care provider fraud and abuse include:

  • Billing for services that weren't provided
  • Duplicate submission of a claim for the same service
  • Billing for durable medical equipment items that weren't ordered or provided
  • Misrepresenting the service provided
  • "Upcoding"—Charging for a more complex or expensive service than was actually provided
  • Billing for a covered service when the service actually provided wasn't covered

Examples of member fraud and abuse include:

  • Using a member ID card that doesn't belong to that person
  • Adding someone to a policy that isn't eligible for coverage
  • Failing to remove someone from a policy when that person is no longer eligible
  • Forging or altering bills
  • Misrepresenting physical conditions or medical history in order to obtain multiple prescriptions

Member notice: unauthorized phone calls and texts

Some of our мembers report receiving phone calls or text messages claiming to be from Blue Cross Blue Shield of Massachusetts. Members may be asked if they suffer from or experience pain and are offered free topical pain medicine, free DNA test kits, diabetic supplies, or durable medical equipment. Members may also be asked to confirm certain information like their member ID number, password, date of birth, doctor’s name, or date of last service.

These calls and texts are not from Blue Cross , nor did we authorize them. We would never ask for your password via text or unsolicited phone call. If you receive one of these calls or texts, don't give anyone any personal information. Our advice is to just hang up.

If you received a call or text like this, we encourage you to contact our Fraud Hotline at 1-800-992-4100 or email us  at [email protected].

Remember, never share your personal information unless you are absolutely sure you're talking to someone you can trust.

Health care fraud and abuse prevention tips

At Blue Cross Blue Shield of Massachusetts, we're working hard to prevent and deter fraud, waste, and abuse, but we need your help. Simple tips that may help you prevent fraud and abuse include:

  • Never share your insurance card with another person. Protect it like you would a credit card.
  • Check your claims history by signing in to your account at MyBlue to verify that you received the services listed.
  • Report suspected fraud and abuse as soon as possible.

How to report suspected fraud and abuse

Please choose any one of the three options listed below:

Telephone:Call our Fraud Hotline at 1-800-992-4100

Email: [email protected].

Mail: Attn: Fraud Investigation & Prevention
Blue Cross Blue Shield of Massachusetts
101 Huntington Ave. Suite 1300
Boston, MA 02199-7611

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ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. Call 1-800-200-4255(TTY: 711).

ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia con el idioma. Llame al número de Servicio al Cliente que figura en su tarjeta de identificación llamada 1-800-472-2689 (TTY: 711).

ATENÇÃO: Se fala português, são-lhe disponibilizados gratuitamente serviços de assistência de idiomas. Telefone para os Serviços aos Membros, através do número no seu cartão ID chamar 1-800-472-2689 (TTY: 711).

ATTENTION : si vous parlez français, des services d’assistance linguistique sont disponibles gratuitement. Appelez le Service adhérents au numéro indiqué sur votre carte d’assuré appel 1-800-472-2689  (TTY : 711).

注意:如果您讲中文,我们可向您免费提供语言协助服务。请拨打您 ID  卡上的号码联系会员服务部 通话 1-800-472-2689(TTY  号码:711)。

ATANSYON: Si ou pale kreyòl ayisyen, sèvis asistans nan lang disponib pou ou gratis. Rele nimewo Sèvis Manm nan ki sou kat Idantitifkasyon w lan (Sèvis pou Malantandan Rele 1-800-472-2689 TTY: 711).

LƯU .: Nếu quý vị n.i Tiếng Việt, c.c dịch vụ hỗ trợ ng.n ngữ được cung cấp cho quý vị miễn ph.. Gọi cho Dịch vụ Hội vi.n theo số tr.n thẻ ID của quý vị Cuộc gọi 1-800-472-2689 (TTY: 711).

ВНИМАНИЕ: если Вы говорите по-русски, Вы можете воспользоваться бесплатными услугами переводчика. Позвоните в отдел обслуживания клиентов по номеру, указанному в Вашей идентификационной карте вызов 1-800-472-2689 (телетайп: 711).

ការជូនដំណឹង៖ ប្រសិនប. ើអ្នកនិយាយភាសា ខ្មែរ សេ  វាជំនួយភាសាឥតគិតថ្លៃ គឺអាចរកបានសម្  រាប ់អ្នក។ សូមទូរស័ព្ទទ ៅផ ្នែ កសេ  វាសមា  ជិកតាមល េខន  ៅល.  ើប ័ណ្ណ សម្  គាល ់ខ្លួ ខ្លួ នរប ស់អ្នក ហៅ 1-800-472-2689 (TTY: 711) ។

ATTENZIONE: se parlate italiano, sono disponibili per voi servizi gratuiti di assistenza linguistica. Chiamate il Servizio per i membri al numero riportato sulla vostra scheda identificativa chiamata 1-800-472-2689 (TTY: 711).

참고 : 한국어를 사용하는 경우 언어 지원 서비스를 무료로 사용할 수 있습니다. 신분증에있는 전화 번호 1-800-472-2689 (TTY : 711)로 회원 서비스에 연락하십시오.

ΠΡΟΣΟΧΗ: Εάν μιλάτε Ελληνικά, διατίθενται για σας υπηρεσίες γλωσσικής βοήθειας, δωρεάν. Καλέστε την Υπηρεσία Εξυπηρέτησης Μελών στον αριθμό της κάρτας μέλους σας (ID Card) κλήση 1-800-472-2689 (TTY: 711).

UWAGA: Osoby posługujące się językiem polskim mogą bezpłatnie skorzystać z pomocy językowej. Należy zadzwonić do Działu obsługi ubezpieczonych pod numer podany na identyfikatorze zadzwoń 1-800-472-2689 (TTY: 711).

ध्यान दें: य दि  आप ह िन् दी बोलते ह ैं, तो भा षा  सहाय  ता  सेवा एँ, आप के लि ए नि :शुल्क  उपलब्ध ह ैं। सदस्य  सेवा ओं को आपके आई.डी. कार  ्ड पर दि ए गए नंबर पर कॉल करें  कॉल 1-800-472-2689 ( टी .टी .वा ई.: 711).

ધ્યાન આપો:  જો તમે ગુજરા તી બોલતા  હો, તો તમને ભા ષા કીય  સહાય  તા  સેવા ઓ વિ ના  મૂલ્યે  ઉપલબ્ધ છે. તમા રા  આઈડી કાર  ્ડ પર આપેલા  નંબર પર Member Service  ને કૉલ કરો કૉલ કરો 1-800-472-2689 (TTY: 711).

PAUNAWA: Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit na mga libreng serbisyo para sa tulong sa wika. Tawagan ang Mga Serbisyo sa Miyembro sa numerong nasa iyong ID Card tumawag 1-800-472-2689 (TTY: 711).

お知らせ:日本語をお話しになる方は無料の言語アシスタンスサービスをご利用いただけます。ID カードに記載の電話番号を使用してメンバーサービスまでお電話ください 呼び出す 1-800-472-2689(TTY: 711)。

ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstützung zur Verfügung. Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen 1-800-472-2689 (TTY: 711).

ຂໍ້ຄວນໃສ່ໃຈ: ຖ້າເຈົ້າເວົ້າພາສາລາວໄດ້, ມີການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາໃຫ້ທ່ານໂດຍບໍ່ເສຍຄ່າ. ໂທ ຫາ ຝ່າຍບໍລິການສະ ມາ ຊິກທີ່ໝາຍເລກໂທລະສັບຢູ່ໃນບັດຂອງທ່ານ ໂທ 1-800-472-2689 (TTY: 711).

BAA !KOHWIINDZIN DOO&G&: Din4 k’ehj7 y1n7[t’i’go saad bee y1t’i’ 47 t’11j77k’e bee n7k1’a’doowo[go 47 n1’ahoot’i’. D77 bee an7tah7g7 ninaaltsoos bine’d44’ n0omba bik1’7g7ij8’ b44sh bee hod77lnih call 1-800-472-2689 (TTY: 711).

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