​Help fight against health insurance fraud and abuse

March 25, 2021

Independence's Corporate and Financial Investigations Department (CFID) continues to add value to our fight against health insurance fraud and abuse. CFID detects, investigates, and reports potential fraud and abuse with the help of confidential information received from many stakeholders, including providers, members, employees, and members of the public. Information received assists our analysts, auditors, and investigators in their work.

COVID-19

Unfortunately, fraud exists e​verywhere. Independence, like many other organizations, has received reports of potential frauds and scams related to COVID-19. We continue to work diligently with law enforcement partners and the private sector to identify cyber threats and fraud in all forms. The Federal Bureau of Investigation (FBI), Department of Health and Human Services-Office of Inspector General (HHS-OIG), and Centers for Medicare & Medicaid Services (CMS) have received complaints of scammers using the public's interest in COVID-19 vaccines to obtain personally identifiable information (PII) and money through various schemes.

Please remind your patients, our members, to be aware of individuals attempting to profit from this emergency. Everyone should remain diligent in protecting personal and health insurance information. Some of the reports we have received include:

  • individuals and businesses selling fake tests, treatments, and cures for COVID-19 online;
  • phishing emails from entities posing as trusted organizations like the World Health Organization or the Centers for Disease Control and Prevention (CDC);
  • online sellers falsely claiming to have in-demand products like cleaning, household, and health and medical supplies;
  • unsolicited calls, emails, or home visits from individuals offering free services or supplies in exchange for member ID numbers;
  • advertisements or offers for early access to a vaccine upon payment of a deposit or fee;
  • requests asking members to pay out of pocket to obtain the vaccine or to put their name on a COVID-19 vaccine waiting list;
  • offers for members to undergo additional medical testing or procedures when obtaining a vaccine;
  • marketers offering to sell and/or ship doses of a vaccine, domestically or internationally, in exchange for payment of a deposit or fee;
  • unsolicited emails, telephone calls, or personal contact from someone claiming to be from a medical office, insurance company, or COVID-19 vaccine center requesting personal and/or medical information to determine recipients' eligibility to participate in clinical vaccine trials or obtain the vaccine;
  • claims of U.S. Food and Drug Administration (FDA) approval for a vaccine that cannot be verified;
  • advertisements for vaccines through social media platforms, email, telephone calls, online, or from unsolicited/unknown sources;
  • individuals contacting members in person, by phone, or by email to advise that the government or government officials require they receive a COVID-19 vaccine.

Follow these tips

Providers can encourage their patients, our members, to avoid fraud by following these tips:

  • Review medical claims submitted at ibx.com for accuracy.
  • Protect their health insurance card.
  • Protect his/her identity and not provide a Social Security Number.
  • Decline to provide insurance information to anyone who is not directly providing them care.
  • Be cautious of unsolicited telemarketers and recruiters.
  • Follow guidance and recommendations from the CDC and other trusted medical professionals.
  • Check the FDA's website (fda.gov) for current information about vaccine emergency use authorizations.
  • Consult their state's health department website for up-to-date information about authorized vaccine distribution channels and only obtaining a vaccine through such channels.

Cyber fraud prevention

There are general online and cyber fraud prevention techniques providers can use. Providers can recommend patients adopt these techniques to protect against fraud:  

  • Verify the spelling of web addresses, websites, and email addresses that look trustworthy but may be imitations of legitimate websites.
  • Ensure operating systems and applications are updated to the most current versions. Update anti-malware and anti-virus software and conduct regular network scans.
  • ​Do not enable macros on documents downloaded from an email unless necessary and after ensuring the file is not malicious.
  • Do not communicate with or open emails, attachments, or links from unknown individuals.
  • Never provide personal information of any sort via email; be aware that many emails requesting personal information may appear to be legitimate.
  • Use strong two-factor authentication if possible, using biometrics, hardware tokens, or authentication apps.
  • Disable or remove unneeded software applications.

Join us in the fight against health care fraud

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. You can report suspicious activity using any of these methods:

  • Online. Submit the online Fraud & Abuse Tip Referral Form
  • By phone. Call the confidential anti-fraud and corporate compliance toll free hotline at 1-866-282-2707 (TTY: 1-888-789-0429), 8:30 a.m. to 4:30 p.m., Monday through Friday.
  • By mail. 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

Learn more

For additional information on how you can help fight fraud and abuse, please visit the​ Anti-fraud and Financial Investigations section of our website.​

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