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Identify

 

Identify Healthcare Fraud & Abuse

 

Insurance fraud costs you money in the form of higher healthcare costs. In fact, losses to fraud account for an estimated 10% of what's spent on healthcare annually. At Patrius Health, our associates are dedicated to stopping fraud. However, we still need help from people like you.

 

Helping Patrius Health uncover fraud is easy. All you have to do is:

  • Know what to look for
  • Keep watch
  • Report suspected fraud and abuse

 

What to look for:

Common types of healthcare fraud include:

  • Filing false claims or billing services that were not performed - when policy holders or medical care providers submit claims or bill services to receive payment for services that weren't provided.
  • Including misleading information in an application for coverage - a person lies about a relationship to a contract holder or deliberately gives incorrect information to receive benefits not entitled to.
  • Using ID cards that belong to someone else - using another person's insurance ID card to receive or pay for services one isn't eligible for.

 

Keeping Watch:

  • Read any Explanation of Benefits (EOB) you receive carefully
  • Take note if you seem to be paying unusually high charges for regular services
  • Understand what services your benefits provide

 

Report Suspected Fraud and Abuse:

We need your help in identifying cases of fraud and abuse. After all, only you know the services you received. If you see something on an Explanation of Benefits (EOB) that doesn't look right or if it lists a service you don't think was performed, contact your doctor or healthcare provider to question it. If you still have questions or concerns after talking to your provider, complete the online form to report suspected fraud and abuse or call our fraud hotline at: 1-885-950-3595.

 

Medicare Site Stock ID

H1347_MKT5WEB
Last Updated: 09/30/2024 21:09

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© 2025 BlueCross BlueShield of Alabama is an independent licensee of the BlueCross BlueShield Association.

Third Party Website Disclaimer

You are about to leave Patrius Health's website and enter a website operated by Prime Therapeutics, LLC. Prime is our business associate and is an independent company that provides pharmacy benefit management services to Patrius Health health plans. Prime has agreed to follow Patrius Health's privacy and security policies regarding the confidentiality and protection of your personal health information.

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To continue, click "Accept". If you want to stay on the Patrius Health website, click "Cancel".

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You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website to learn more about our Dental Plans. The site is operated by Blue Cross and Blue Shield of Alabama and all Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information apply here as well.

To continue to our Commercial website, click "Accept." If you want to stay on the Blue Cross Medicare products website, click "Cancel".

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This link takes you to another web site. Some areas of our site may provide links to other external sites that we don't own, control or influence. We reference sites that we think might be useful or of interest to you, but we are not responsible for the content or privacy practices used by other site owners. Information contained in the external sites is not endorsed by BCBSAL.

To continue, click "Accept". If you want to stay on the Blue Cross website, click "Cancel".

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You are about to leave Blue Cross and Blue Shield of Alabama Medicare website to visit the UTIC Insurance Company website. The site is operated by UTIC Insurance Company and all of UTIC Insurance Company's privacy and security policies regarding the confidentiality and protection of your personal health information apply.

To continue, click "Accept." If you want to stay on the Blue Cross and Blue Shield of Alabama Medicare website, click "Cancel."

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You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website to visit one of our social media sites. Although content of our social media sites is maintained by Blue Cross, Blue Cross does not control the security and/or privacy practices of these external social media sites. Therefore, Blue Cross advises users of these sites against sharing any personal health information or any other information the user would otherwise not feel comfortable being made public. Blue Cross shall not be liable for privacy breaches, security incidents or similar events due to the use of social media sites.

To continue, click "Accept." If you want to stay on the Blue Cross and Blue Shield of Alabama Medicare website, click "Cancel."

Third Party Website Disclaimer

This link takes you to another web site. Some areas of our site may provide links to other external sites that we don't own, control or influence. We reference sites that we think might be useful or of interest to you, but we are not responsible of the content or privacy practices used by other site owners. Information contained in the external sites is not endorsed by Patrius Health.

To continue, click "Accept." If you want to stay on the Patrius Health Medicare products website, click "Cancel."

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To continue, click "Accept." If you want to stay on the Patrius Health Medicare products website, click "Cancel."

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To continue, click "Accept." If you want to stay on the Patrius Health Medicare products website, click "Cancel."

Third Party Website Disclaimer

You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website to learn more about vision plans. The site is operated by Blue Cross and Blue Shield of Alabama and all Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information apply here as well.

To continue to our Commercial website, click "Accept." If you want to stay on the Blue Cross Medicare products website, click "Cancel".

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To continue, click "Accept." If you want to stay on the Patrius Health's website, click "Cancel".


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Per Federal Guidelines, you are eligible for Plan F only if you became eligible for Medicare prior to January 1, 2020.

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