NC fights Medicaid fraud with analytics
States budgets are under pressure, and Medicaid funding is often among the hardest hit. But in some states, including North Carolina, data analytics software is helping to uncover millions of dollars in potential savings through the detection of fraudulent Medicaid billing. North Carolina's department of health and human services began collaborating with IBM in 2010 to develop analytics to help identify suspicious billing patterns by healthcare providers. To date, North Carolina has identified $191 million in potentially false Medicaid claims by 206 outpatient behavioral health providers in the state.
- Sharp HealthCare Leaves Pioneer ACO Program
- Acute Kidney Injury Gets New Focus
- CNO Leads $1M Charge for New Scrubs, Uniforms
- Interventional Radiology No Longer a Sub-Specialty
- NFP Hospitals' Revenue Growth at 'All-Time Low'
- Half of All Primary Care, Internal Medicine Jobs Unfilled in 2013
- MA an Insurance Proving Ground for Providers
- mHealth Tackles Readmissions
- Targeting Self-Insured Populations
- PCI: Concerns Mount About Appropriateness