How to Report Fraud
Most health care professionals and organizations that provide medical supplies and services are honest. Unfortunately, there may be some who are dishonest. If you think a doctor, hospital, pharmacy, or durable equipment company or supplier is doing something wrong or committing fraud, please contact us. It is important to protect the integrity of government programs like the Medicare-Medicaid Alignment Initiative (MMAI). If you suspect fraud, waste or abuse, please report it.
Examples of Fraud include:
- Overusing services that you don't need
- A provider billing for services not done
- False answers on an application
- Using someone else's ID card
- Performing unnecessary medical services
- Supplying unnecessary medical equipment
Report by Phone
To report Fraud, you can call Member Services, or the Blue Cross Community MMAI Special Investigation Department (SID) at 1-800-543-0867. You can call 24 hours a day, seven days a week. Calls to the fraud hotline can be made anonymously or in your name and are always confidential.
This online fraud reporting form can be completed and sent to the SID.
Report by U.S. Mail
Blue Cross and Blue Shield
Special Investigations Department
300 E. Randolph Street, 35th Floor
Chicago, Illinois 60601
You can also report Medicaid fraud
If you have any questions, Contact Us.