Overutilization, provider-member collusion and duplicate billing reveal themselves in the links, with prioritization before payment.
Book a diagnosisOverutilization, provider-member collusion and duplicate billing emerge from repetition, matching dates and the proximity between who requests, who performs and who receives. With fewer people than cases, prioritization is the result.
The audit starts following the link that explains the claim.
We model providers, members, procedures and claims to identify overutilization, collusion and duplicates, and prioritize medical audit before payment.
Map my caseTwo hours with a specialist to map data, relationships and the next step for your case.
