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Healthcare Provider Fraud Software

Avoid Healthcare Provider Fraud to Bolster Your Government Agency

One form of fraud a government agency may encounter is healthcare provider fraud. Healthcare provider fraud happens when a provider submits dishonest forms — sometimes on purpose, sometimes on accident — in exchange for a more substantial amount of healthcare benefits. Providers may also convince others to falsify information for a larger payout. You don’t want to pay out more than you already are, which means it’s important to catch this fraud before it happens. With public records search engine tools from Tracers, it’s easier than ever to avoid this type of fraud.

Uncover Hidden Fraud Patterns

Patterns are an important thing to pay attention to when it comes to understanding and uncovering fraud. Unfortunately, too many groups ignore this all-important concept. Many organizations resort to reactive fraud avoidance, which encourages them simply to let fraud happen, then react to it after the fact.

You need to be proactive, not reactive. When you’re able to analyze past instances of fraud and continue to keep an eye on fraud today, you’ll start to notice patterns. With those patterns, it’s easy to predict more accurately when a healthcare provider is more likely to submit fraudulent forms and documents.

Verify Licenses and Other Crucial Information

Though it’s definitely not common, it’s also not unheard of for individuals to make up credentials completely so they can get a higher payout from insurance. For example, someone might pretend there were two doctors instead of just one, or they might claim they hold a license when they actually don’t have one.

You can use Tracers to make sure this basic information is accurate. For example, if you notice that someone’s claiming a specific license that they don’t actually have, not only is this a red flag for fraud, but it may even be a red flag for criminal activity, which you can then catch early.

Gather Information Using Your Preferred Methods

There are a number of ways to gather information about individuals. This is true no matter what you’re using to gather information, and it’s especially true once any kind of software enters the mix. Tracers gives you access to three different methods of gathering information:

These all work best for different types of organizations. Do you receive dozens of healthcare claims everyday? Consider the batch processing option for large amounts of work. Are you rarely busy, with only a few requests every week? Try out individual searches to process them as they come in.

Discover Conflicts of Interest

A conflict of interest is typically a warning sign of fraud. Although not every conflict of interest indicates fraud, it’s at least a good place to start looking, because it’s more likely that someone’s committing fraud if it benefits multiple people, not just them.

These conflicts of interest can be difficult to pinpoint because you need access to information not just about an individual, but about an individual’s family and general circle of colleagues. The good news is that Tracers offers you information to all of that information, so you can more easily discover when conflicts of interest happen.

Make Your Services Safer and More Effective

Every government service should strive to make its services safer for its residents. Of course, when you’re dealing with the healthcare industry, this safety is very literal; by uncovering healthcare provider fraud, you can make sure that only high-quality, honest healthcare providers continue to work in the field.

To do this, you need to make sure you have the top tools in the industry. No matter what type of individuals you’re dealing with every day, your government services should be just as high-quality as the services that a for-profit body offers. The tools at Tracers are quality enough for any industry, including government and non-government industries.

"Before Tracers, I had to log in at a desktop to obtain investigative data. Now I can log on anywhere I can get internet. Many times investigators are doing surveillance away from their desktops and they can use their phones to perform searches."

Mark Jenkins
Department of Veteran Affairs

Why Should Your Agency Choose Tracers’ Tools?

Many people are used to government tools being slipshod and barely-working. Oftentimes, this is because the branches of the government that need Tracers’ tools rarely have the budget to purchase high-quality tools. However, Tracers’ tools aren’t just for government organizations, and that’s actually what makes them perfect for government organizations.

The tools at Tracers strive to be the very best for industries of all types. That includes everything from corporations to law enforcement, which means that Tracers’ tools need to be top-notch. When you choose software from Tracers for your day-to-day government needs, you can rest assured that you’ll be getting the best information available.

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