Tips to Prevent Health Care Fraud
Reducing health care fraud is a joint effort between Blue Cross and Blue Shield of New Mexico (BCBSNM), its providers and its members.
Here are some ways you can help fight health care fraud:
- Understand your what your plan covers.
- Review all Explanation of Benefits (EOB) statements. Make sure you had the medical exams, tests and treatments with the provider shown on the EOB.
- Understand what you are responsible to pay – know if your plan requires you to pay a deductible or copay.
- Guard your BCBSNM member ID card, Social Security Number and other personal information. Call BCBSNM as soon as possible if your card or insurance information is lost or stolen.
- Sign and date only one claim form per office visit.
- Never lend your BCBSNM member ID card to someone else.
- Don't give out your information if medical services or equipment are offered as "free." Be sure you understand what is "free." Also find out what you and BCBSNM will be charged.
- Before you have a medical test or treatment, ask your doctors exactly what they want you to have and why. If in doubt, get a second opinion from another doctor.
- Monitor what prescription drugs you use. Make sure the medicines billed to BCBSNM are correct.
- Be aware of phony sales pitches over the phone. Do not disclose your insurance or personal information.