About Us
Since 2000 BCSI has performed hundreds of successful investigations.
Our integrated team of investigators and support services ensure that the investigations are conducted in a timely fashion with leading edge techniques.
BCSI is considered the platinum standard of the industry based on the quality and the wide spectrum of its services as well as the expertise of the investigators.
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Mitigating Health Insurance Fraud
The final part in our four-part series on health benefits abuse and fraud looks at how this type of fraud can be reduced. This mitigation can be done by employees, companies, and the insurance providers
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Consumers
Employees must understand that the colleagues who are committing fraud are positively gaining from it, while it is the plan members who are the ones faced with the negative impact. Thus, reporting fraud is a necessary step in eliminating it.
In addition, individuals can take steps to protect their identity and healthcare information from being stolen. Protect your personal health number and when utilizing online accounts create complex passwords and subsequently protect them.
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Company
Furthermore, companies need to take steps to monitor the claims that their employees make in regards to their capacity to fulfill the requirements of their job. If they can show their insurance provider that they are taking steps to mitigate fraud the cost of the insurance plan for their employees may in fact decrease. Companies can set up an anonymous email or tip hotline for their employees to voice concerns.
Insurance Provider
Finally, insurance companies can also take a role reducing health insurance fraud. They can examine claims for abnormalities and frequency of submission. This is often done by computers due to the large number of claims. They can also investigate healthcare providers who they believe may be making false claims. Insurance providers may also conduct randomized audits to check for validity of claims.
Finally, it is essential to create an anonymous outlet where consumers can submit their suspicions about a member or service provider committing health insurance fraud.
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Contact Us
BCSI has the skills and resources to investigate health
insurance fraud. Please feel free to contact our offices at 604-922-6572 for a free consultation with one of our lead investigators and learn how BCSI will assist you in developing a personalized investigation strategy to mitigate insurance fraud.
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