Your Expert SIU Services Partner for Healthcare Fraud, Waste, Abuse, and Error
Today’s insurance companies not only need to protect their network against fraud, waste, and abuse — they need to minimize the impact on their Medical Loss Ratio (MLR) and prevent provider abrasion.
Areas of Expertise
The HCFS SIU team includes clinical staff who are DCs, LPNs, RNs in addition to Accredited Health Care Fraud Investigators (AHFI), and as Certified Professional Coders (CPC, CPC-P, CDEO, CPMA, CDC) and Certified Fraud Examiners (CFE), and routinely provides training nationally for various organizations, including the NHCAA, AHIP, HPA, ACAP, and more.
Analyze Claims Data
We’ll help find alerts needing evaluation and develop sustainable cases.
Detect System Weaknesses
Because too much time and money is lost to false alarms.
Prevent Fraud
With policy recommendations and educational resources to improve claims fraud detection.
Investigate Cases
Let our experts help address suspicious activity.
Medical Records
Review records to determine coding accuracy.
Education or Training
We provide FWA training, consultations on coding, record reviews, data analysis, investigative processes and more.
Customer Testimonial
“Their tools and their customer service, it’s outstanding — they’re the best in the space.”
Sr. Manager, Payment Integrity
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Customer Support & Training
Our committed customer support doesn’t stop at the sales desk.