10.0 Fraud Prevention
We want to encourage Providers to learn how to recognize fraud in order to help stop it.
10.1 Help Prevent Identity Fraud
Prior to accepting coverage and completing a sale for a new Member, check that they have either one piece of PRIMARY ID or two pieces of SECONDARY ID to verify their identity as a Member.
Primary ID
Secondary ID
10.2 Whistleblower Hotline
Pacific Blue Cross is committed to protecting the integrity of the benefit plans provided to Members. The Whistleblower Hotline is a program that allows Members, Providers and employees to anonymously report fraud and unethical behaviour.
Administered by an independent third party on behalf of Pacific Blue Cross, all information relating to the report is kept private, confidential and secure, including any communication from the reporting individual.
Providers are required to report all relevant information to Pacific Blue Cross immediately (and not more than 72 hours) after becoming aware of actual or potential Fraudulent Claims.