Practice caution with requests for patient information

Our Corporate and Financial Investigations Unit has been made aware of provider offices receiving fraudulent requests for patient information, national provider identifier numbers and provider signatures. These requests, which may come to you by standard mail, email or fax, often include clues that indicate they are not legitimate; for example:

• Use of a generic “BlueCross BlueShield” logo; that is not the official Blue Cross Blue Shield of Michigan, Blue Care Network or Blue Cross and Blue Shield Association logo
• Obvious grammatical errors (wrong tense, misspelled words, random or inconsistent capitalization)
• Phone numbers that don’t match

DME fraud is becoming more common

One of the largest health care fraud schemes of the past few years involves durable medical equipment, costing the health care industry tens of millions of dollars a year. Our Medicare members can be particularly susceptible to these schemes. For example, fraudulent telemarketers may reach out to seniors offering “free” DME equipment to members, intentionally trying to confuse them to get Medicare to pay for equipment that isn’t actually vetted by a medical professional (and that the member often never receives).

If you suspect a request may be fraudulent, don’t respond to it

When we conduct mass requests for medical records or patient information, we often notify you through a provider newsletter article or a provider alert. If you’re suspicious of a request that you receive, you can contact our Fraud Hotline at 1-844-STOP-FWA (1-844-786-7392) or send an email to StopFraud@bcbsm.com. We may ask you to share the request so we can check its legitimacy.

For more useful information, check out the Victimized Provider Project section** of the Centers for Medicare & Medicaid website. The Victimized Provider Project helps keep providers from being held liable for overpayment for claims paid that are the result of identity theft.

By working together, we can help eliminate fraud, an effort that will improve patient safety and reduce costs.

**Blue Cross Blue Shield of Michigan and Blue Care Network don’t own or control this website.