Regence BlueShield Enhances Efforts to Protect Members From Identity Theft

Nov 03, 2006, 00:00 ET from Regence BlueShield

    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, 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

SOURCE Regence BlueShield