Blue Access for Employers

Health Care Fraud Prevention and Reporting

Fraud may cost the health care industry (both public and private payers) more than $200 billion each year* and can lead to your employees experiencing physical and mental harm as a result of schemes in which a provider performs unnecessary or dangerous procedures.

Reducing health care fraud is a collaborative effort between Blue Cross and Blue Shield of New Mexico, our employer groups, producers, providers and members.

Report Any Suspected Incidence of Fraud

Our Special Investigations Department (SID) is one of the most effective in the industry. The staff includes individuals with medical, insurance and law enforcement backgrounds, as well as data analysts experienced in detecting fraudulent billing schemes. The SID aggressively investigates reports of fraud and refers cases for criminal prosecution.

Report by Phone
(800) 543-0867

The toll-free Fraud Hotline operates 24 hours a day, seven days a week. You can remain anonymous or provide information if you want to be contacted by a member of the SID.

Report Online
www.bcbsnm.com/sid/reporting

This website address links to an online fraud reporting form that can be completed and sent to the SID electronically.

Report by U.S. Mail
Blue Cross and Blue Shield
Special Investigation Department
300 E. Randolph Street, 11th Floor
Chicago, Illinois 60601

*Source: The Federal Bureau of Investigation (FBI), Financial Crimes Report to the Public for Fiscal Year 2008