Report Fraud Online

You can use this form to tell us about suspected health care fraud. Please note that the information you submit isn't secure or encrypted.

You may remain anonymous. All information we receive is strictly confidential. But if you'd like a response from us about your report, please include your contact information.

Blue Cross Blue Shield of Michigan maintains a policy that enforces non-retaliation and non-intimidation against those who report potential concerns.

Your information

(optional - you may remain anonymous):

First Name This field is required.

Last Name This field is required.

Street Address This field is required.

City This field is required.

State

ZIP Code

Email This field is required.

Phone Number

Insured's information

(the person who carries the insurance):

First Name This field is required.

Last Name This field is required.

Subscriber ID, Formerly Enrollee ID This field is required.

Street Address This field is required.

City This field is required.

State

ZIP Code

Phone Number

Person or company your complaint is about:

Name This field is required.

Street Address This field is required.

City This field is required.

State

ZIP Code

Phone Number

Date and description of your complaint

(when the event took place, and what occurred):

Date of Incident(s) This field is required.

Summary of Complaint

This field is required.

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