What are other ways Blue Cross detects fraud?

Blue Cross prevents and identifies fraud by analyzing data and collaborating with outside organizations.

In addition to fraud reported by members or doctors, Blue Cross also prevents and identifies fraud by:

  • Analyzing data – We are implementing new, highly sophisticated fraud detection software to further analyze claims data and identify unusual billing patterns of medical procedures, and any patterns of potentially fraudulent behavior.
  • Collaborating with outside organizations – When appropriate, we work with the National Health Care Anti-Fraud Association, the Blue Cross and Blue Shield Association, law enforcement agencies, and public and private organizations to stop fraudulent activities.
     

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Blue Cross prevents and identifies fraud by analyzing data and collaborating with outside organizations.