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HCBSPAP105 - Suspected Fraud Payment Suspension - New
Blue Cross of Idaho·ID·Reimbursement
Effective date
May 1, 2024
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho can now suspend claim payments or require pre-payment review when their Special Investigations Unit (SIU) receives credible fraud allegations against providers. Claims will be routed to SIU for review and medical record requests before payment.
Action Required
Immediately: Ensure all medical records are complete and readily available for any claims that may be flagged for SIU review. Establish process to respond promptly to medical record requests from Blue Cross of Idaho SIU to avoid claim denials. Verify all billed services have adequate supporting documentation before claim submission.