Two Fixes for Behavioral Health Fraud

By HMS
Mar. 22, 2016

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Behavioral health fraud Healthcare fraud is a $70 billion a year problem – and growing. An HMS webinar addresses two of the latest ways to respond in the increasingly troublesome area of behavioral health claims:

  1. Shift cost-containment efforts from recovery to pre-pay. By recently combining a pre-pay audit platform with a post-pay clinical platform, HMS shares best practices that payers can use to stop erroneous payments before they happen.
  2. Apply new predictive models to behavioral health claims. The application of fresh variables based on linear regression to existing systems promise to increase recovery rates by up to 30%. Investigators will learn about the key variables to help reduce false positives – and target the most significant fraudulent claims.

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