Wednesday, March 23, 2016

Former Blue Cross Blue Shield employee accused of insurance fraud

A former Blue Cross and Blue Shield employee has been arrested, accused of defrauding BCBS of nearly $40,000.

Officials suspect that Frank John Leli submitted more than 350 claims for medical services that were never provided. Officials found that only 12 claims were found to be legitimate. As a result of the false claims, Leli collected about $40,000 in insurance benefits, authorities said.

BCBS said it began investigating Leli in August 2014 after noting patterns of multiple submitted medical claims on his own behalf. BCBS notified the Division of Insurance Fraud last November.
DIF uncovered hundreds of additional claims that Leli filed related to treatments by two separate Georgia-based chiropractors, officials said.

The chiropractors told officials that Leli wasn’t a former or current patient.

Leli was arrested and is being held on a $150,000 bond in the Duval County Jail. He is charged with insurance fraud, grand theft and an organized scheme to defraud.

Leli faces up to 15 years in prison.

The Georgia Bureau of Investigations and BCBS were involved in the investigation.

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