Help Us Stop Fraud

Do you know who our biggest ally is in the fight against insurance fraud? You are!

BlueCross BlueShield of South Carolina works with federal, state and local law enforcement agencies to prosecute fraud cases. Tips from customers and providers help us do our job. Why is this important to you?

Because if you're a customer, you pay hard-earned money for your health plan coverage. When folks try and beat the system and make us pay more than our share, rates can rise for everyone!

If you're a health care professional, you work hard to establish a good reputation in the community. If you're a member of the BlueCross network, you are one of our valuable partners in helping your patients enjoy secure health coverage. When folks file false claims or other health care professionals commit fraud, it hurts us all.

There are many different types of fraud. Here are just a few examples:

Customers:

  • Letting someone else who does not have BlueCross coverage use their ID cards
  • Filing false claims
  • Changing dates of service

Doctors and Health Care Professionals:

  • Billing for services the patient never received
  • Filing claims for unnecessary procedures
  • "Unbundling" charges — taking one overall procedure and filing each step as a separate item
  • Filing a claim for a more expensive procedure than the one actually given

Remember, you can remain anonymous when you report something you think might be fraud! If you have information to share with us, please send us an e-mail.