Home | 7/25/2011 Issue | Article

CMS has new way to target claims

Effective Jul 21, 2011
Published Jul 25, 2011
Fraudulent claims will no longer be paid first and investigated later come July 1 when CMS launches its new predictive modeling initiative. CMS’s new tactic against fraud, a product of health reform, will be similar to technology used by credit card companies. Claims will be analyzed using risk scoring technology that will identify suspicious Medicare claims before they are paid.
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