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Computer programs help flag insurance fraud.(Strategic notes)
- Article from:
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Health Care Strategic Management
- Article date:
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December 1, 2006
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Copyright informationCOPYRIGHT 2006 HC Pro. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)
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The Centers for Medicare & Medicaid Services and private health insurers are using computer programs that can flag potential fraud even before medical claims are paid, according to a November 7 article in USA Today.
The computer programs search claims data for suspicious patterns by comparing practitioners' claims with their peers' claims and larger claims ...