How it Works: Health Insurance Fraud Investigation 

Posted by IntegrityM | | Investigations

The U.S. government won over $5 billion in healthcare fraud cases in 2021 according to the HHS Annual Report. That’s a huge number—but it only covers the dollar amount of fraud successfully found through investigations and reporting. Combatting the billions of dollars in fraud each year is the work of specialized investigators committed to keeping…

Avoid “Investigative Leakage” for More Effective and Efficient Healthcare Fraud Investigations

Posted by IntegrityM | | Investigations

One good way to measure the effectiveness and efficiency of a Special Investigative Unit (SIU) is to determine its return on investment (ROI). While some companies may conduct routine evaluations of their SIUs, one area that is hidden and thus difficult to measure is the existence of wasted investigative man-hours, or, what we call, investigative…

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