Fraud, Waste and Abuse
Fraud, Waste and Abuse (FWA) costs health plans and drug plans operating in the Medicare, Part D, Medicaid and Commercial spaces billions of dollars a year. Plans need to stay ahead of the curve to stem losses.
ATTAC Consulting Group assists plans to evaluate of FWA programs and provides guidance on program design and implementation.
- Evaluation of claim data mining methods and application of technology
- Evaluation and guidance in staff training, including customer service representatives
- Special Investigation Unit functions and processes
- Case documentation
- Regulatory and law enforcement agency interfaces and reporting
- Risk assessments
- Cost allocation validation and model review
- Claim and financial systems control review
- Regulatory reporting review
- Internal audit protocols
- Internal reporting and investigation