In these uncertain times, one thing is clear; the COVID-19 pandemic will have repercussions in the medical claims and payment world for months if not years to come.

Here are just a few of the ways that COVID-19 could increase instances of medical claims fraud, waste, and abuse:

  • Relaxed regulatory and reimbursement environment
  • Loosening of telemedicine guidelines
  • Changes in preauthorization procedures
  • Identity Theft
  • Authorized Provider acceptance changes (Medicare/Medicaid)
  • Increased coding complexity
  • Provider financial pressure

What do you need to protect yourself from COVID-19 Induced FWA?

  • Advanced AI to pinpoint healthcare claims that contain fraud, waste, and abuse
  • Ability to instantly adapt to changing billing patterns
  • Ability to immediately identify unusual provider behavior
  • Tools to identify unusual patient behavior
  • Power to examine claims Prepay and Post Pay
  • A vehicle to engage and communicate with the Patient to validate medical claims information

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