SEATTLE, Nov. 3 /PRNewswire/ -- When your wallet gets stolen, you call
in your credit cards right away. But what about your health plan card? The
latest twist on identity theft is using stolen health plan cards to get
medical care or prescription drugs on somebody else's tab.
To help protect members from identity theft, Regence developed a new
policy in collaboration with its Special Investigation Unit (SIU), an
internal group charged with thwarting health care fraud and abuse schemes.
Beginning immediately, when a member contacts Regence Customer Service to
report a stolen or lost health plan card:
-- A Customer service representative enters the information into
Regence computer system.
-- The SIU automatically receives notification of the lost or stolen
-- Pharmacy Services automatically receives notification (if the member
has a pharmacy benefit) of the lost or stolen card.
-- The member is issued a new card.
With the timely alerts provided by the new procedure, SIU and Pharmacy
Services can respond if unusual activity occurs on that member's account.
Regence members also have 24/7 electronic access to their claims data at
myregence.com, so they can monitor claims paid for possible fraud.
"Most cases of stolen ID health plan cards relate to drug seekers, who
use the card to get certain prescription drugs like the painkiller
Loratab," said Alex Johnson, a former fraud investigator for the Federal
Bureau of Investigation and the head of Regence's Special Investigative
Unit. That is why Regence's new card replacement policy alerts the Pharmacy
department. "It also puts up the necessary red flags so the SIU will open a
case to quickly pursue fraudulent activity that could occur."
Thieves siphon an estimated $100 million a day-or $85 billion a year-in
fraudulent use of health dollars through a variety of inventive schemes,
according to industry and federal sources. Figures like these have led
Regence to launch its own Special Investigative Unit, which recovered
approximately $8 million dollars as a result of its activities in 2005.
Whether schemes are crude or sophisticated, "Consumers are the first
line of defense against health care fraud," said Johnson, "Your health
plan's explanation of benefits deserves the same scrutiny as your bank
statement, your credit card bill or your phone bill. Remember to contact
your health insurance carrier right away if you get a bill for services or
medications that you never received."
About Regence BlueShield
Regence BlueShield is a leading health plan in Washington that provides
health care coverage to more than one million members. Regence BlueShield
is part of Regence, the largest health insurer in the Northwest/Mountain
State Region, operating Blue Cross/Blue Shield plans in Oregon, Washington,
Utah and Idaho. Through these plans, Regence provides health, life, vision
and dental insurance to nearly three million members. Regence plans are
not-for-profit, independent licensees of the Blue Cross and Blue Shield
Association. For more information, visit www.wa.regence.com.
SOURCE Regence BlueShield