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Managing fraud can be difficult, particularly in challenging economic times. In fact, research has shown that economic hardship often impacts human behaviours in unexpected ways—one of which is an increased likelihood of fraudulent behavior—and, often times, it’s the long-term costs of fraud that get overlooked. Alberta Blue Cross has a strict zero tolerance policy toward any fraud or abuse of the benefit plans we administer.
While fraud remains rare, we each have an active role to play in preventing it. It’s important to know what each of us can do.
How does fraud affect you?
Each time a claim is submitted to Alberta Blue Cross, it’s validated against the rules of that specific member’s plan to determine whether it is eligible for reimbursement. If it qualifies, the claim is paid out. Fraudulent claims for products or services increases costs to benefit plans, which in turn causes premiums to increase for all customers.
What’s our approach?
We take a rigorous approach to fraud prevention. For example:
What can you do?
If you suspect any fraud involving your benefit plan, call the Alberta Blue Cross fraud hotline toll free at 1-866-441-8477 or contact us through the Alberta Blue Cross Fraud, Privacy and Ethics Reporting service. All information is kept strictly confidential, including your identity, and you can report fraudulent activity anonymously.
If you’re a plan sponsor, educate your employees about how to recognize fraud and report it.