Horizon Blue Cross Blue Shield of New Jersey

Newark - Horizon Blue Cross Blue Shield (Horizon BCBSNJ) in New Jersey today announced that the fight against health insurance fraud led to a saving of $ 45.4 million in 2014. Since the creation of the Special Investigation Department (SIU) by Horizon BCBSNJ in 1983, Horizon BCBSNJ 's anti - cheating action saved $ 261 million in membership.

Douglas Falduto, executive vice president of administration and chief security, says: Said. Official of Horizon BCBSNJ. "With state-of-the-art software and intelligent detective work, we continue to improve the ability to identify and investigate suspicious claims and approximate real-time claims."

In 2014, the SIU opened 1,318 new cases of suspected suspicion. Horizo ​​n BCBSNJ After a confidential report to the anti-fraud hotline (1-800 - 624 - 2048), a lot of investigations began. The company received 2,450 hotline in 2014

Fraud and abuse can involve health care providers and medical consumers. A common example is as follows.

"Horizon endeavors to ensure that members' health care expenditure is properly used, and that employees, health workers, and members should pay attention to suspicious activities and claims and report to the SIU It is recommended."

The American Health Care Fraud Association estimates that annual health care fraud losses cost tens of billions of dollars

Horizo ​​n Blue Cross Blue Shield, the oldest and largest health insurance company in New Jersey, is a non-profit health service company paying taxes that offers a variety of medical, dental and prescription insurance products and services I will. Through collaboration with doctors and hospitals, Horizo ​​n BCBSNJ leads innovation in health care in New Jersey and offers an innovative, patient-centered program that rewards high-quality medical treatment, not the amount that patients receive It offers. For more information, please visit http://www.HorizonBlue.com. Horizon BCBSNJ is an independent license holder of Blue Cross and Blue Shield Association and serves over 8 million members.

While a few offenders often hide health care fraud, members of Horizon Blue Cross Blue Shield in New Jersey and employers lose millions of dollars each year. Therefore, Horizon BCBSNJ continues to invest in state-of-the-art inspection technology and invests in sharp team researchers to protect the integrity of New Jersey's healthcare service system. In 2015, the special team of experts - Horizon BCBSNJ's Special Investigation Bureau (SIU) - generated $ 43.2 million savings, identified as a combination of collection fund and loss avoidance, and 988 new fraud cases occurred.

Newark - Horizon Blue Cross Blue Shield (Horizon BCBSNJ) in New Jersey today announced that the fight against health insurance fraud led to a saving of $ 45.4 million in 2014. Horizon BCBSNJ has created the maximum / recovery prevention total since the creation of the 1983 Special Research Division (SIU) by BCBSNJ. Since 2005, Horizon BCBSNJ's fraud prevention measures reduced members' s $ 261 million. Douglas Falduto, executive vice president of administration and chief security, says: Said. Official of Horizon BCBSNJ. "With state-of-the-art software and intelligent detective work, we continue to improve the ability to identify and investigate suspicious claims and approximate real-time claims."