Storytelling draws stakeholders to the fraud fighting flame

Sharing stories about fraud schemes, criminal prosecutions or recovered money can contribute to a special investigations unit's visibility and success.

"A rapidly growing number of leading companies have discovered the power of story as a communication tool," according to Insurance Thought Leadership. "When stories are told consistently and systematically, everyone in the organization works together better, stays focused on the mission and remains productive, ensuring continued success in the midst of change."

Whether it's detecting a fraud scheme, preparing a case referral for law enforcement, training staff to recognize and report misconduct, or demonstrating the value of SIU efforts, fraud fighting is a story-rich function. Though proprietary aspects of investigations can't be shared, here are examples of how SIUs have leveraged the power of stories:

When corporate executives see the value of SIU operations in combating health insurance fraud, they typically support their operations well. "If you do a good job telling your story, it gets the leadership's attention and they see the importance of having an effective SIU," consultant Jack Price told FierceHealthPayer: Anti-Fraud. Recognizing this, Harrisburg, Pennsylvania-based United Concordia dedicated a website page to success stories of its dental SIU.

Fraud detection requires pattern recognition, and patterns are story forms. "The claims tell a story. The data tell a story. You just have to decipher it," WellPoint Director of Enterprise Investigations Alanna Lavelle told FierceHealthPayer: Anti-Fraud.

Further, storytelling can be used in anti-fraud staff training programs. One insurer developed training based on fraud schemes portrayed in films, all of which told stories employees remembered long afterward.

It's a modern application of an old idea: "Stories reach people at deeper level than a litany of facts and figures, and stay with people longer," the Insurance Thought Leadership article noted. This led Harvard University professor Howard Gardner to conclude that "storytelling is the single most powerful tool in a leader's toolkit."

Stories connect employees with corporate culture, the article noted. "By incorporating storytelling as a part of your business practices and regularly including relevant stories on the agenda for meetings ...  you will propel your organization toward its goals. Red-hot stories will keep everyone fired up and eager to pass them along to everyone they encounter."

For more:
- here's the Insurance Thought Leadership article
- see United Concordia's list of anti-fraud success stories

Suggested Articles

The HHS OIG is asking for an additional $23.7 million to support fraud oversight that has benefited from an emphasis on data analytics.

A New York surgeon was sentenced to 13 years in prison for fraud and more physician practice news from around the web.

A federal judge has ruled that the U.S. government’s remaining fraud case against UnitedHealth can move forward.