Our experts have knowledge and experience in developing complex clinical fraud and abuse detection algorithms.
- Healthcare Fraud and Abuse - Pattern Analysis, Detection and Recovery Services
According to an estimate, each year, almost 100 billion dollars are lost to fraud and abuse in US healthcare system. Development of fraud detection algorithms and systems in healthcare is a complex challenge. To zero in on fraud patterns, multidisciplinary specialized skills are needed, which include - clinicians, physicians, billing experts, informatics experts, fraud investigators and technical experts.
Our fraud and abuse team has all the above expertise including, clinicians with experience at "big four" accounting and management consulting firms, who have worked on healthcare fraud and abuse detection projects that have helped several US state governments to detect and recover significant healthcare fraud monies.
(*Adapted from a recent DoJ and HHS report)