If you've ever purchased a swing set or bicycle for your child, you likely recall the hours it took to progress from a neatly packaged box of parts to a finished product. For health plans' special investigative units (SIUs), the notion of wading through a pile of false leads before finding actionable information may often feel like a Saturday spent in the backyard with limited tools and confusing instructions.
Verscend believes in a "no assembly required" approach to case referrals with turnkey allegations. The concept is simple: fraud, waste, and abuse (FWA) vendors should do the legwork to find and validate aberrant billing behavior, explore patterns, conduct pre-case research, and deliver all the right information to an SIU so that it can immediately open and pursue good cases.
View our webinar to learn more about the turnkey allegation approach, including:
- The challenges that many SIUs face in assembling the right information to build a case
- Best practices in analytics, technology, and human expertise for shortening the path from lead to allegation
- Examples of turnkey allegation success stories