HHS shares early results of fraud detection program
At the recent Chicago Fraud Prevention Summit, HHS Secretary Kathleen Sebelius highlighted the amazing results of just the first month of the Automated Provider Screening program that Equifax helps run.
To begin, it’s now a lot more difficult for bad actors to get their foot in the door.
Today, before you can become a Medicare provider, you have to go through a rigorous third-party review process that will make sure you meet all the requirements to bill Medicare.
We have a comprehensive database that allows us to systematically screen all current and prospective providers against other key sources like provider licensing and criminal records. If you get banned from one Medicaid program or Medicare, you get banned from all Medicaid programs.
And if a doctor retires, dies, or becomes ineligible, we know about it and can remove his information from our system. In the past, out-of-date and invalid provider numbers would remain on the rolls — like a forgotten backdoor entrance allowing criminals to sneak in and start billing bogus claims. But no longer.
I am proud to announce today that we have already removed 3,000 ineligible providers from the Medicare program identified in just the first month of these new screening procedures.
For more information about how screening for fraud up-front can help your insurance and benefit programs save money, contact one of our specialists.
Recommended For You
The CERCA Spring Conference, held on May 16, capped a broadly successful 2018 filing season that saw tax identity theft reduced by […]
Recently, the Affordable Care Act (ACA) State-Based Healthcare Marketplaces in California, Covered California, and Vermont, Vermont Health Connect, sent ACA […]
Fraudulent account activity and identity fraud are both significant drains to today’s business resources. In the era of online and mobile commerce, […]
Fraudsters are a smart group. With each fraud prevention method that’s introduced, they figure out ways to work around it. […]