Why Combatting Healthcare FWA Is So Critical

Fraud, waste, and abuse is so rampant in healthcare that it has its own acronym: FWA. Yet many people remain unconcerned about it, mostly because they don’t understand how critical it is to detect fraud as early as possible — and hopefully before it happens with a health claims or Medicare fraud detection solution.


What makes combatting FWA so vital? Check out the following reasons.


FWA Buries the American Healthcare System in Unnecessary Costs

Current estimates put a price tag of nearly one trillion dollars on healthcare fraud in the USA. That’s a huge burden that everyone ends up paying for at the end of the day. Without checks and balances in place, such as through AI health claims review protocols, healthcare providers wind up giving essential money to people and companies that don’t deserve it.


Individuals Who Successfully Commit FWA Crimes Will Continue Until Stopped

Criminals who abuse the healthcare system rarely stop of their own accord. Instead, they’ll continue to commit medical fraud until a solution like a Medicare fraud detection system pinpoints their illegal activity. At that point, authorities can step in, ultimately ensuring that these so-called “white collar criminals” pay for their misdeeds.



Plenty of Yet-To-Be-Detected FWA Has Happened During COVID-19

Unfortunately, COVID-19 has become a new way for some fraudsters to rob healthcare providers of dollars. Though no one’s clear on how much FWA has happened in the wake of coronavirus, professionals who work in the healthcare industry are certain it’s taking place regularly. The fastest way to cut down on COVID-19-related Medicare and Medicaid fraud and other types of fraud is to allow AI-enabled Medicaid and Medicare fraud detection software to quickly flag possible trouble spots.


Millions More Aging Americans Will Tap Into Medicare Soon

As Baby Boomers and members of Generation X age, they will start to take advantage of the Medicare system. Medicare only works well if it’s free from FWA. Consequently, placing a high priority on Medicare fraud detection now makes sense to keep costs down later. In fact, paying for Medicare fraud detection as a preventive measure makes as much sense as getting annual check-ups.


FWA is everyone’s issue, not an isolated concern relegated to healthcare. The sooner we implement AI-linked fraud detection measures, the more money we can funnel into helping everyone stay well.

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