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Help fight against fraud, waste, and abuse

February 29, 2016

Last year, the Federal Bureau of Investigation estimated that between 3 and 10 percent of all health care spending in the U.S. went towards payment of fraudulent claims. Fraud has real effects on health care costs and quality of care. Independence?s Corporate and Financial Investigations Department (CFID) continues to add value to our fight against health insurance fraud, waste, and abuse (FWA). CFID detects and investigates potential areas of FWA with the help of confidential information received from many stakeholders, including providers, members, employees, and the general public.

Information received assists our analysts, auditors, and investigators in determining whether potential FWA has occurred. Some of the most common potential FWA schemes reported to CFID over the past year include:

  • billing for services not rendered;
  • health care identity fraud;
  • prescribing of controlled substances for illicit purposes;
  • improper use of procedure codes.

If you suspect health care fraud against Independence and/or you, we urge you to report it. All reports are confidential. You are not required to provide your name, address, or other identifying information.

Submitting a report

You can submit your report to us in one of three ways:

  1. Submit the Online Fraud & Abuse Tip Referral Form electronically.
  2. Call the confidential anti-fraud and corporate compliance toll-free hotline at 1-866-282-2707 (TTY: 1-888-789-0429 ).
  3. Mail your report. Write a description of your complaint, enclose copies of any supporting documentation, and mail it to:

    Independence Blue Cross
    Corporate & Financial Investigations Department
    1901 Market Street, 42nd Floor
    Philadelphia, PA 19103

As a result of CFID?s efforts last year, more than $100 million was recovered in FWA-related claims and 88 fraud cases were referred to law enforcement or regulatory agencies. Multiples of the recovered amount were saved through the detection, prevention, and shutting down of improper payments and schemes. Many of these recoveries and referrals started with information someone provided to CFID.

Please join us in the fight against health care fraud.


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
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