Cost Containment

Fighting Healthcare Fraud And Abuse

Up to $170 billion of employers’ healthcare benefit dollars ends up in the wrong hands each year because of fraudulent claims submitted primarily by doctors, hospitals, labs and billing agencies. That means unscrupulous individuals siphon away up to 10 percent of each employer’s healthcare dollars, or $600 for each employee.

To protect employers’ healthcare benefit dollars, CoreSource teamed up with The Sentinel Group, a recognized leader in the fight against fraud and abuse. When claim analysts believe they have uncovered fraudulent or abusive activities, claims are submitted to The Sentinel Group for investigation. The Sentinel Group screens the claims against its database of providers, and suspect claims are passed on to investigators for further scrutiny.