FWA Insights: Stopping “phantom providers” with prepay intervention

One of the most elusive fraud, waste, and abuse (FWA) schemes facing health plans today is the rise of “phantom providers.” These are entities that exist only long enough to submit fraudulent claims and disappear before detection. Phantom providers, also known as ghost networks, are often calculated, fast-moving, and sometimes international in scop...

• Published date: 03-11-2025 07:11 PM