Learn about the process Blue KC employees use to report violations.
If you believe that a violation of the Code has been committed, you must report that information to Blue Cross and Blue Shield of Kansas City (Blue KC). You may do so in any of the following ways:
Talk directly to your supervisor.
Your supervisor is knowledgeable about the requirements of your business unit and may be your best source of information or means to resolve an issue.
Talk with someone else in your business unit management.
If you continue to have concerns after discussing the issue with your supervisor, or you would feel more comfortable discussing it with another management person, raise the issue with another management-level person in your business unit.
Discuss the issue with the Compliance Office or Legal Services Division.
You may raise the issue with any other person or group within BCBSKC assigned to handle compliance matters.
Report your concerns through Blue KC’s Hotline at 816-395-2255.
If your concerns remain, or you would feel more comfortable doing so, you may contact the Compliance Office through Blue KC’s Hotline or its internal e-mail address _Compliance_Office@bcbskc.com. You may make an anonymous telephone call if you wish, but you are not required to do so. Identifying yourself makes it possible to contact you in order to clarify information or ask follow-up questions. You may also make an anonymous report by using the Incident Report Form available on Blue Access.
In certain circumstances you may report directly to the Audit Committee of the Board of Directors.
Use this resource if you have reason to believe that Blue KC or an individual has, or has attempted to, submit a false or fraudulent claim for payment to the United States Government; or if you have reason to believe that Blue KC has engaged in improper financial or accounting practices or reporting. You may make a report to the Audit Committee by leaving a message on the Audit Committee Hotline at 816-395-2408. You may make anonymous reports using the Audit Committee Hotline. All communications are kept confidential to the extent possible.
All reports to the Compliance Office, or to the Audit Committee, are confidential. However, there may be a point where an individual’s identity may become known or may have to be revealed, for example, in response to a government inquiry or investigation.
Blue KC maintains a corporate policy on Privacy of Health Information that governs how employees and others access, use and disclose our enrollees' protected health information. Suspected violations of that policy should be reported to the Privacy and Security Office as set forth in that policy.
A member of our workforce who suspects that the Privacy Policy and Procedures, the HIPAA Privacy Rules or other applicable federal or state privacy law has been violated by another workforce member or business associate must report the suspicion to our Privacy and Security Office in sufficient detail to permit the matter to be investigated and to prevent or mitigate any deleterious effects. Reports may be made anonymously.
It is Blue KC’s policy not to take, or allow to be taken, any retaliatory action against an employee, provider, vendor or other person who reports in good faith any actual or suspected violation of the privacy policy by a Blue KC officer or employee.
If you report a violation through any of the methods identified above, you have met the basic requirements of the Code and Blue KC’s Compliance Program. You have a further obligation to cooperate in any investigation or resultant action that may be triggered by your report. It is Blue KC’s policy that anyone who makes a report in good faith will be protected from all forms of retaliation.