The National Health Care Anti-Fraud Association (NHCAA) estimates that tens of billions of dollars spent on healthcare each year are the direct result of outright fraud. Money that goes to pay fraudulent claims makes everyone’s premiums higher and out-of-pocket costs go up, this is a problem that affects all of us.
Be cautious of “free” medical services or exams, copayment or cost-share waivers or services advertised as “covered by insurance.” Services advertised like this could be fraud schemes designed to illegally bill you and your health plan.
You are the best defense against healthcare errors and fraud. Read your Explanation of Benefits (EOB) carefully to make sure that all the services you are being billed for are services you actually received. If you have questions about the services a provider has billed, contact their office first. In most cases, errors are the result of an administrative mistake, and the provider will gladly correct it.
How you can help
Here are a couple ways you can protect yourself from fraud:
If you suspect fraud, call Blue Cross of Idaho’s fraud hotline at 800-682-9095 or email firstname.lastname@example.org.