Those who seek to commit healthcare fraud and abuse are continually adapting, and at the same time, the increasingly complex healthcare landscape presents fresh opportunities for new or continuing areas of wasteful and erroneous billing. Payers are challenged to stay on top of it all.
Verscend’s Fraud Detection solution combines advanced analytics and clinical investigative review to deliver actionable case referrals to cost containment staff and special investigations units (SIU). The result is pre- and post-pay protection from aberrant billing and known and emerging fraud schemes.
Our latest fact sheet explores how Fraud Detection improves prevention and recoveries with:
- Multi-layered detection analytics that inform and evolve
- Clinical investigative review for actionable referrals
- A production application that increases efficiency
- Case tracking for reduced complexity
- Ongoing support to keep your program running smoothly