Fraud happens every day in every healthcare system. The majority of fraud remains undetected (and thus invisible) forever. Because most fraud is invisible, we tend to focus only on what we know about. This is a big mistake. However, ignoring known scams would be an even bigger mistake. I’ve collected information about cases around the US to give you an overview of the wide variety of methods of operations we know about. This is just the tip of the iceberg.

Resources for the Press: Frequently Asked Questions, Mathias Consulting In the News and Public Appearances.

Fraud is a serious problem that affects every healthcare system. Each health plan loses from 3% to 30% to fraud, waste and abuse. Reducing fraud losses is one of the few ways that a health plan can cut costs without hurting their members or providers. Investment in fraud control typically saves $6 to $12 for every dollar spent, yet health systems have not invested in the level of controls that will effectively stop fraud. To dramatically decrease the expenses caused by the fraud that can be found in every healthcare system, invest in these ten high-priority activities: