Sometimes fraud is easy to spot, like when someone steals your name and insurance information to get prescription drugs. Sometimes it’s not so easy, like a chiropractor who prescribes a back brace you don’t really need.
Signs of Fraud
Health care fraud is a felony that can endanger your health, your access to health insurance, and put your personal information at risk. Protect yourself and others by learning how to spot fraud.
Incorrect information on your Explanation of Benefit (EOB) statement can indicate fraud, especially if the date is wrong or you see a service listed you didn’t receive. It’s worth it to report a suspicious EOB. Otherwise you could be responsible for charges you shouldn’t have to pay.
What is Waste?
Health care spending that can be eliminated without reducing the quality of care.
What is Abuse?
Improper behaviors that create unnecessary costs:
Fraud vs Waste and Abuse?
The following examples clarify the distinction between Fraud, Waste & Abuse:
Help us eliminate this costly problem. If you suspect fraud, please contact us:
BlueShield of Northeastern New York
Attn: Special Investigation Unit
PO Box 15013
Albany, NY 12212
All information will be held in the strictest confidence.