Healthcare Fraud Services

Industries

Health Care

Three percent of America’s $1.7 trillion annual health care expenditure—an astounding $51 billion—is lost to fraud and overcharging, according to the NHCAA. What’s more, this costly abuse is growing at a rate of over 5% per year. We offer comprehensive verification, validation and authentication tools in order to help you mitigate risk.

We offer comprehensive verification, validation and authentication tools in order to help health insurers combat fraud and protect their organizations.

Verify the identities of providers and suppliers

Order medical records

Improve your collections and subrogation efforts

Process and investigate claims more efficiently

Prevent and investigate fraud

Find new customers

Screen prospective employees, volunteers and contractors

InstantID, Accurint®, Medical Records Retrieval, Collection Management Solutions, Targeted Consumer Lists, Data Enhancement, Data Hygiene, and Contractor Screening are not consumer reporting agencies as such term is defined in the federal Fair Credit Reporting Act, 15 USC 1681 et seq. ("FCRA"). InstantID, Accurint®, Medical Records Retrieval, Collection Management Solutions, Targeted Consumer Lists, Data Enhancement, Data Hygiene, and Contractor Screening reports do not constitute consumer reports as such term is defined in the FCRA, and accordingly InstantID, Accurint®, Medical Records Retrieval, Collection Management Solutions, Targeted Consumer Lists, Data Enhancement, Data Hygiene, and Vendor Screening reports may not be used to determine eligibility for credit or for any other purpose provided for in the FCRA.

RiskView™ and LexisNexis Employment Screening are consumer reporting agencies as such term is defined in the federal Fair Credit Reporting Act, 15 USC 1681 et seq. ("FCRA"). RiskView™ and Employment Screening reports constitute consumer reports, and may only be accessed for permissible purposes as provided in the FCRA.

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I can't think of a better alliance between public and private sectors in combating health care fraud

National Health Care Anti-Fraud Association (NHCAA)

How can we help your company? For more information about our solutions call (800) 869-0751 or email us now

•	Maintain critical compliance requirements in a rapidly changing legislative environment.
•	Streamline and accelerate your hiring processes by integrating with your current human resource information system.
•	Easily accommodate high volume hiring peaks, in which you must screen and hire a large volume of workers for specific projects at different locations.

•	Enable automatic review of each claim to ensure data accuracy with solutions that quickly process large volumes of data and confirm, append or update key data elements, including addresses and National Provider Identifiers.
•	Identify suspicious claims early in the review process with online verification of key patient and provider information, including bankruptcy filings, criminal records, as well as determine provider assets to assist with recovery efforts.
•	Shorten the investigative process through integrated solutions and proprietary, data-linking technology that returns detailed search results to the user’s desktop in seconds.

Risk & Information Analytics