The Sentinel Group Prevents Nearly $10 Million in Healthcare Fraud and Abuse for Its Clients
Posted on: Tuesday, 18 March 2008, 18:00 CDT
The Sentinel Group, a leader in healthcare anti-fraud and abuse services, saved its clients close to $10 million in 2007 by avoiding payment of potentially fraudulent and abusive health claims.
Serving a wide range of payers including third-party administrators, insurance companies and self-insured employer groups, The Sentinel Group employs a large team of fraud investigators to screen and analyze healthcare claims for possible fraud and abuse. The organization is supported by the IBM Fraud and Abuse Management System (FAMS) technology, which helps identify suspect claims based on non-standard billing patterns, as well as by sophisticated statistical modeling techniques.
"The combination of experienced investigators and state-of-the-art technology allows The Sentinel Group to detect what ordinary claims paying systems just can't, such as when providers bill for services not rendered," said Kelli Garvanian, Vice President, The Sentinel Group.
According to the U.S. Attorney General and the Department of Justice, healthcare fraud is one of the country's top priorities, right behind terrorism, violent crime and illegal drugs. As much as 10 percent of all healthcare expenditures maybe lost to fraud every year, based on statistics from the General Accounting Office.
"After fraud perpetrators discover that the claims they submit to a firm are being scrutinized by The Sentinel Group, they often give up their aberrant billing practices or ply their tactics elsewhere," said Julie Malida, President, The Sentinel Group. "If necessary, we cooperate with federal and state agencies to prosecute offenders to the full extent of the law."
About The Sentinel Group
The Sentinel Group, a division of Optimal Benefits Services, Inc., based in Lake Forest, Ill., is a recognized leader in the healthcare anti-fraud and abuse industry. The company has one of the most experienced teams of fraud investigators, has performed healthcare fraud investigations for 19 years, and is supported by sophisticated, state-of-the-art technology and in-depth intelligence gathered nationwide from healthcare providers. For more information, visit http://www.sentinelgrouponline.com.
Source: Business Wire
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