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Preventing Healthcare Fraud in Property/Casualty Claims |
By Dr. Barry Johnson, President of HealthCare Insight |
| According to the National Health Care Anti–Fraud Association, up to 10 percent of the nation’s annual healthcare outlay is lost to fraud and abuse. With healthcare spending projections of $2.4 trillion for 2008, the healthcare fraud challenge has an estimated total cost between $72 billion and $240 billion. This staggering financial loss potential has prompted many payors to investigate and implement sophisticated pre– and postpayment fraud and abuse solutions. » more
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Securing Personally Identifiable Information:
Are You and Your Vendor on the Same Page? |
By Naomi Botuck, CPCU, Director of SBU1/SBU2 Application Development, ISO |
| Technological advances over the past decade or so have made it possible for detailed personal information about individuals to be compiled and shared more quickly, easily, and cost–effectively than ever. And while the benefits to business, consumers, and society as a whole are numerous, a flurry of protection and privacy issues arise with each new advance. Because litigation involving data privacy and security is growing, it’s critical for workers comp carriers to ensure the ongoing security and integrity not only of their own data–transport systems but also of the vendor systems they work with. » more
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The Workers Compensation Fraud:
(The Latent Crisis) |
By Donald T. DeCarlo, Esq., AMCOMP Chairman/President, and Roger T. Thompson, AMCOMP Consultant |
| Cumulative trauma. Asbestos. Medical and drug costs. Terrorism. The workers compensation system has dealt with many crises in its past. Now, with an economy in crisis, we have the makings of the next crisis — fraud. What do insurers need to do to prevent the various forms of fraud? In these difficult economic times, diligence in efforts to identify and prosecute cases of fraud will be critical. » more
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Arthur Cadorine
Vice President of ISO’s Information Acquisition, Development and Service
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