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Why health care fraud detection requires payment integrity alignment

Why health care fraud detection requires payment integrity alignment

In one health care organization, a provider was reviewed and cleared through routine payment integrity processes. Months later, that same provider became the subject of a fraud investigation, based on patterns that had been present all along. Both reviews were technically correct within their scope. But together, they revealed something more concerning: The system itself
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Why health care fraud detection requires payment integrity alignment originally appeared in KevinMD.com.

Source: kevinmd.com –

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