Verizon expands health fraud prevention to payers, government

Verizon is offering private health insurers and government agencies involved in healthcare the same fraud prevention solution that it has already piloted for the Centers of Medicare and Medicaid Services (CMS) through a subcontract with Northrop-Grumman. Called Verizon Fraud Management for Healthcare, the system uses predictive modeling technology to examine incoming claims and route potentially fraudulent claims to case managers for investigation. According to Verizon's announcement, "the platform is designed to help identify fraud before payments are made, reducing improper payments and the administrative and legal costs associated with traditional pay-and-chase recovery operations." FierceHealthIT