Healthcare Incidents Investigations

Fighting Healthcare Fraud

According to a new report, every year the world is losing some £313 billion to fraud and error – More than three times the UK NHS budget for 2011/12.

These losses include prescription fraud costing £100 million per year, optical fraud amounting to £18.9 million, and £36.3 million in dental fraud.

It is greatly unjust to allow fraudsters and organised criminals to steal money that should be used for public healthcare, especially at a time when organisation need to make their resources go further. The need for detection, disruption and prevention on fraudulent activity within healthcare system has never been greater.

Check whether this problem directly affects your organisation:

  • Healthcare fraud a growing problem?
  • Under pressure to reduce costs?
  • Need to carry out more investigations with less resource?
  • Would benefit from a more systematic approach?
  • Counter-fraud department under resourced?
  • Welcome assistance in the identification of repeat incidents across all aspects of fraud within your organisation?

If, like most healthcare organisations, you answered “yes” to these questions, ABM’s robust Investigation and Case Management solution can help.

How abmintellicase™ Can Help

abmintellicase™ Case Management helps your healthcare organisation to investigate healthcare fraud to protect your revenue and improve your organisation’s performance in countering fraud:

–       Assists with the prioritising of investigations across the organisation

–       Protect the reputation and finances of your organisation

–       Reduce the cost of investigations

–       Uncover and eliminate more fraudulent activity by transitioning the organisation from reactive to proactive

–       Demonstrate to tax payers that healthcare fraud is being taken seriously

Key features:

  • Centralised system, accessible at any location by all staff or investigators, to record intelligence surrounding fraud
  • Manage all fraud investigator’s activity and information in one place
  • Automated workflow to improve working procedures
  • Flexibility to manage all types of fraud,
  • Keep all intelligence, information and case files in one place for joined-up working to identify individuals engaging in multiple scams
  • Visual linking and spatial mapping tools identify links between people, organisations, addresses and fraud cases
  • Web-based software supports home working to improve flexibility and reduce costs
  • Prioritise investigation resources
  • Process applications, records and cases faster
  • Eliminate errors and duplications
  • Improve communication with other authorities and agencies
  • Manage investigations from start to finish, including automated production of documentation to support enforcement

Read more about abmintellicase™Case Management