Health care fraud, waste and abuse have a negative effect on the health care industry and our nation. Health care fraud costs billions of dollars each year. It impacts all of us in the long run.
Health care fraud leads to:
- Higher health care costs, including premiums
- Limited health care resources
- Lower consumer confidence in our health care system
Examples of health care fraud include billing for:
- A service that was never performed
- A more expensive service, supply or piece of equipment other than what was really provided
- Deliberate misrepresentation of services in order to be reimbursed
We have a special investigations department to fight fraud. The SID staff includes people from diverse backgrounds, such as:
- Medical providers, including doctors and nurses
- Insurance industry experts
- Professional coders
- Law enforcement
SID also has a Data Intelligence Unit to partner with SID investigators to find and stop fraud, waste and abuse.
When appropriate, SID refers fraud cases for criminal prosecution.
How do I report fraud?
If you suspect fraud, there are ways to report it.
• Report by phone: 1-800-543-0867
The toll-free Fraud Hotline is available 24 hours a day, 7 days a week. You can remain anonymous, or you can let us know if you want to be contacted.
• Report online: Complete this fraud report. This report is automatically sent to SID upon submission.
• Report by mail: Blue Cross and Blue Shield of Oklahoma
Special Investigations Department
1400 S. Boston Ave.
Tulsa, OK 74119