By Tim Dineen, Director, Special Investigations Unit at Horizon Blue Cross Blue Shield New Jeresey

If crisis does indeed breed opportunity, then the COVID-19 outbreak is shaping up as a potential boon for scam artists.

During these uncertain times, fraudsters are increasingly taking advantage of people’s fears and confusion to obtain their personal information or sell bogus tests and treatments.

Right now, people are so laser-focused on the coronavirus and gathering as much information as they can, that their normal barriers are down. If they read an email that says “coronavirus,” or someone calls up claiming they’re from the Centers for Disease Control and Prevention (CDC), they’ll listen.

At the Special Investigations Unit (SIU) at Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ), we’re continuing to monitor for this type of behavior. Horizon BCBSNJ members should apply the diligence they’ve always practiced around suspicious communications and unknown people to today’s uncertain times. How can members do that? Here’s what to look out for and how to protect yourself.

What scams should I look out for?

Many fraudsters are relying on the classic techniques of robocalls and fake emails to reel people in. But they’re giving them a coronavirus twist. Some examples include:

• Bogus ads for vaccinations or medications to treat the disease. Currently, there are no approved vaccines for COVID-19. You should always consult with your doctor regarding any suggested medications.

• Unexplained or unauthorized laboratory tests, treatment or prescriptions appearing on your Explanation of Benefits (EOB) statement.
• “Phishing” emails about COVID-19 containing attachments that, once opened, can infect your computer and steal your private information.
• Ads for products that are ineffective against COVID-19 such as herbal teas or supplements.

The SIU has also gathered intelligence of people knocking on doors, offering COVID-19 screenings and tests right at home. Claims are then submitted for various treatments, including medical equipment, that are not at all related to the treatment of COVID-19.

Who’s most vulnerable to these scams?

We have not seen information to indicate that fraudsters are targeting a particular demographic. More likely it’s the areas of the country hardest hit by the pandemic – including New Jersey and New York. Residents of these states can expect more scams coming their way.

How can Horizon BCBSNJ members protect themselves against attempted scams?

Be wary of people you don’t know promising things that can’t be verified. For example, some fraudsters are claiming they have a vaccine against the disease, which doesn’t yet exist.

In addition, you should continue to be diligent when you receive suspicious emails. These may purportedly come from organizations like the CDC, but they’ll contain grammatical or spelling errors, or ask you to click on a link or open an attachment. These links could download malicious software onto your computer. Pause for a moment and ask yourself if these communications look real.

It’s always best to use trusted sources, like the actual website of the CDC.

What should I do if I find a lab test on a recent EOB statement that I know I didn’t have?

In this situation, someone may have gotten hold of your Horizon BCBSNJ member number and used it to bill false claims. You should call Horizon BCBSNJ’s Special Investigations Unit (SIU) hotline and the SIU team can investigate the claim:

• If you are covered by Horizon NJ Health, call 1-855-372-8320

• If you are covered by any other Horizon BCBSNJ plans, call 1-800-624-2048

What should I do if I’ve realized I may have fallen for a scam?

It’s important not to “feel silly.” Fraudsters are becoming more sophisticated in their scams, tricking more people. Instead, try to resolve the issue as quickly as possible. If the scam is related to your Horizon BCBSNJ plan, call the Horizon SIU hotline. If it’s a more general scam, contact law enforcement. The U.S. Department of Justice has a website dedicated to this issue.

How is Horizon BCBSNJ safeguarding its members’ personal information?

While the coronavirus situation is new, fraudulent attacks on Horizon BCSBNJ unfortunately aren’t. The SIU has years of experience dealing with a range of health care scams. Horizon BCBSNJ has a robust cybersecurity program to keep up-to-date on online schemes and a claim utilization program to detect abnormal changes in members’ use of health care services.

While Horizon BCBSNJ has put systems in place to protect a member’s identity, individuals also have a role to play in making sure their Horizon BCBSNJ membership number doesn’t fall into the wrong hands. Protect your Horizon BCBSNJ ID like you would your Social Security number. Nobody but you, your doctor and Horizon BCBSNJ ever need your Horizon BCBSNJ ID.

As of April 10, New Jersey’s Attorney General has issued a warning about additional scams that have been reported. Click here to read his announcement.