Provider Secured Services

Home > 2012 Medicare Advantage > Fraud, waste and abuse training

Fraud, waste and abuse training

The Centers for Medicare & Medicaid Services requires all entities and their employees who partner with Medicare Advantage organizations and prescription drug plans to complete annual training to detect, prevent and correct fraud, waste and abuse. These annual training records, including participant names, must be retained and available for inspection upon request. To assist our Medicare partners in meeting this requirement, Blue Cross Blue Shield of Michigan and Blue Care Network developed a slide presentation, available below for your use. Instructions for reporting fraud are also below.

Learn more about fraud, waste and abuse training (PDF).

Report fraud.

Plan basics

• Medicare Plus Blue PPO manual (PDF)
• MA PPO contract documents
• Medicare Advantage library

Coverage details

• Benefit summaries
• Enhanced benefits
• DME coverage
• Medicare Advantage PPO lab network
• Specialty care
• Drugs, drug plans and vaccines

Billing & payment

• Eligibility and coverage
• Billing members
• Submitting claims
• Overpayment
• Reimbursement
• Claims questions and appeals
• If you don't participate with Medicare

Evaluation and management

-->
• Hospice care

Overview & resources

• Other Blue plans (PDF)
• Contact information
• ID card
• FAQs
• CMS Quality Star Ratings program
• Health e-Blue^SM
• Healthy Advantage Rewards
• Fraud, waste and abuse training
• Medicare guidelines
• Medicare resources
• Types of products
• Glossary
• Site map

Evaluation and management

• Hospice care

Care management

• Prior notification and utilization management
• Care management