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CONFIDENTIAL Suspected Fraud/Abuse Referral Date Complaint Received: Investigation Unit Case #: Source of Complaint Line of Business Hotline Blue Cross Telephone Blue Chip Written Major Medical Internal
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What is suspected fraudabuse referral?
A suspected fraud/abuse referral is a report made when there is suspicion of fraudulent or abusive behavior in a certain situation.
Who is required to file suspected fraudabuse referral?
Certain individuals and organizations, such as healthcare providers, insurance companies, and government agencies, are required to file suspected fraud/abuse referrals.
How to fill out suspected fraudabuse referral?
Suspected fraud/abuse referrals can be filled out by providing detailed information about the situation, including the nature of the suspected fraud/abuse and any evidence that supports the claim.
What is the purpose of suspected fraudabuse referral?
The purpose of suspected fraud/abuse referrals is to investigate and address instances of fraudulent or abusive behavior in order to protect individuals and organizations from financial harm.
What information must be reported on suspected fraudabuse referral?
The suspected fraud/abuse referral should include detailed information about the situation, individuals involved, evidence supporting the claim, and any other relevant information.
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