{"id":3103,"date":"2022-07-05T12:23:08","date_gmt":"2022-07-05T16:23:08","guid":{"rendered":"https:\/\/medlogix.com\/?p=3103"},"modified":"2023-05-02T14:31:51","modified_gmt":"2023-05-02T18:31:51","slug":"how-to-effectively-combat-insurance-fraud-in-the-digital-age","status":"publish","type":"post","link":"https:\/\/medlogix.com\/how-to-effectively-combat-insurance-fraud-in-the-digital-age\/","title":{"rendered":"How to Effectively Combat Insurance Fraud in the Digital Age"},"content":{"rendered":"\n
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How to Effectively Combat Insurance Fraud in the Digital Age<\/h4>\n\n\n
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The Coalition Against Insurance Fraud (CAIF) estimates that workers\u2019 compensation insurance fraud costs insurers and employers an average of $30 billion annually<\/a>. In an article posted by the Business Insurance Journal, a New York criminal defense lawyer noted that the pandemic made it easier to file claims under COVID<\/a>, resulting in more overall filing and potentially more people committing fraud. <\/p>\n\n\n\n

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With fraudulent activity continually increasing, it is more important than ever that insurance companies arm themselves with education and resources to protect their business.<\/p>\n\n\n\n

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Types of Fraud<\/strong><\/p>\n\n\n\n

Unfortunately, fraud is a common occurrence in the insurance industry. Although it can look different for each sector, fraud often fits into one of\u00a0three categories<\/a>.<\/p>\n\n\n\n

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  1. Organized \u201crings\u201d that coordinate and execute fraudulent activities on a large scale. <\/li>
  2. Healthcare professionals or staff who inflate costs or charge for services not rendered.<\/li>
  3. Individuals who bolster or fabricate their claim to make money.<\/li><\/ol>\n<\/div>\n<\/div>\n\n\n\n

    Among the insurance categories most vulnerable to fraud is\u00a0workers\u2019 compensation<\/a>. This category presents a challenge because there is the opportunity for fraud at every stage of the claim by multiple parties. For example,\u00a0employers<\/a>\u00a0can misrepresent their payroll or apply under false names to avoid detection of their claim records. In addition, healthcare providers can alter codes, file duplicate claims, or fabricate billing for procedures never performed. Furthermore, employees can falsify injuries or prolong treatment to gain income or benefits without working.<\/p>\n\n\n\n

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    Additional\u00a0fraudulent actions<\/a>\u00a0can include:<\/p>\n\n\n\n