Case study: Highmark Wholecare prevents FWA with Claim Pattern Review

Fraud, waste, and abuse (FWA) requires a robust payment integrity program. From compliance requirements and coding accuracy to the added complexity of Medicaid state regulations, bad actors are always looking for ways to slip through the cracks for their own benefit. For smaller special investigations teams (SIU) dealing with a high volume of claim...

• Published date: 06-11-2024 02:26 PM