Regence warns of vitamin coverage scams
May 18, 2010
Regence members in Washington, Oregon, Idaho and Utah report they are seeing claims for services not received on their explanation of benefits.
The claims were filed on behalf of companies that sell nutritional supplements.
The members bought products from companies whose ads state: “Learn how you can get your nutritional supplements reimbursed up to 100 percent through your insurance provider.”
Regence issued a nationwide alert to all Blue Cross and Blue Shield plans in April, after an investigation showed that parties filing for reimbursement were submitting fraudulent claims from providers involved in the scheme.
The fraudulent claims are coded for legitimate covered services, such as consultations, lab and X-ray, which members did not receive.
In addition, the supplement companies essentially advised consumers to disregard any notes on their health plan’s explanation of benefits about coding for services, alleging the health plan is attempting to pay less for the services.
The alert affects the more than one million Washingtonians served by Regence and 100 million people nationally who are members of a Blue Cross Blue Shield health plan.