Highmark anti-fraud efforts saved $100 million in 2014

Anti-fraud efforts involving data analysis and coding investigations saved Highmark Inc. more than $100 million last year. The Pittsburgh-based insurer's Financial Investigations and Provider Review (FIPR) department--made up of nurses, investigators, accountants, former law enforcement agents and programmers--reviewed more than 2,400 cases in 2014 using audit programs that targeted unusual claims and coding investigations that reviewed inappropriate payments. The FIPR department expects that financial savings tied to fraud prevention will exceed $115 million in 2015. Statement

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