Who We Are & What We Do

Who We Are & What We Do

In response to the rising cost of health care fraud, in 1983 BlueCross BlueShield of Tennessee established an investigative unit dedicated to detecting, preventing and pursuing health care fraud and abuse.

The BlueCross BlueShield of Tennessee Special Investigations Unit (SIU) consists of individuals with backgrounds in, law enforcement, investigations, legal, auditing, claims analysis, and medical professions.

Our Commitment to Fighting Fraud

BlueCross BlueShield of Tennessee's commitment to fighting fraud was made evident by the establishment of the BCBST Special Investigations Unit. Our continued commitment is also evident by the expansion of the department from its original two employees to its present size of nineteen. In addition, BCBST has located part of the Unit in Chattanooga and in Memphis to provide statewide coverage, established a toll-free hot-line for reporting suspected fraud, and created this web site, which may also be used to report suspected fraudulent activities.

Since health care fraud costs you and other consumers of health care services millions of dollars each year, we ask for your help in fighting this waste. Carefully review all charges listed on the Explanation of Benefits you receive from BCBST. If we have paid for services you did not receive or paid an amount you do not think is appropriate, please report this to the SIU by clicking the Report Suspected Fraud button on this page.

This process may result in administrative or civil action taken against the person committing the act, in an attempt to recover dollars lost. Any act believed to be of a criminal nature will be referred to the appropriate law enforcement agency for their consideration.