Government Leaders Join With MedicFP to Fight Healthcare Fraud

Former Governor, Secretary of HHS and CMS leaders collaborate to develop a technology solution to prevent $300 billion in healthcare fraud.

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A Look at Modern Healthcare Fraud

Modern healthcare fraud is a costly crime with an annual price tag of over $320 billion dollars. Data breaches, aggravated identity theft, phantom billing, and medical identification sharing are different ways that fraudsters can steal healthcare data. Have any of…

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In the that you’ve been here, there has been in healthcare fraud committed!


MedicFP Prevents Healthcare Fraud Before Treatment!

MedicFP® has created the only solution to actually prevent healthcare fraud before care. MedicFP addresses growing healthcare concerns related to medical identity theft, medical identity sharing and phantom billing (billing for services not delivered) by enabling payers and providers to verify a patient’s identity, eligibility and presence before care.

Pay-and-Chase Methods Unreliable for CMS

Pay-and-Chase Methods Unreliable for CMS

During testimony given in the recent Healthcare Fraud Investigation Hearing, House Ways & Means Oversight Chairman Peter Roskam stated that data, not time consuming, expensive pay-and-chase methods, work to prevent healthcare fraud loss.

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NAMD 2016

NAMD 2016

NAMD 2016 Fall Conference Booth #114 Hyatt Regency Crystal City, Nov. 6-8, 2016 MedicFP’s solution addresses growing healthcare concerns related to medical identity theft, medical identity sharing and phantom billing by enabling payers and providers to verify a...

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Healthcare Fraud Crisis in the U.S.

Over $360 billion dollars a year are lost to healthcare fraud. That number is on the rise every year.  Out of that $360 billion, the U.S. recovers less than 2%, and funds are being cut for audit and recovery efforts. Recovery is low and will continue to get lower due to the recent reduction of risk adjustment contractor (RAC) funding.

Technology Solution to Prevent Healthcare Fraud

MedicFP is a groundbreaking healthcare technology company that has created the earliest fraud prevention solution in the healthcare lifecycle. This one of a kind solution effectively and accurately prevents healthcare fraud before treatment. MedicFP is a “fraud disrupter” that prevents the most chilling and financially debilitating threats to the security of healthcare: phantom billing, medical identity theft and identity sharing. This solution detects fraud before medical services are rendered and before fraudsters submit the claim. MedicFP fulfills a drastic need in the landscape of healthcare fraud solutions.

Prevent Healthcare Fraud from Phantom Billing

Phantom Billing

Phantom billing occurs when a provider illegally bills a patient’s insurance company for undelivered procedures, equipment or services. Often, these providers don’t even exist and are using stolen provider information. Those who commit this kind of healthcare fraud do so because of the high value vs. low risk of getting caught. For example, in 2016, a South Florida healthcare operator was found guilty of phantom billing $56 million dollars to Medicare. This case was only one example of false billing practices. MedicFP prevents this kind of healthcare fraud.

Prevent Healthcare Fraud from Medical Identity Theft

Medical Identity Theft

According to a leading 2016 study, 89% of healthcare organizations were unable to prevent healthcare fraud and suffered data breaches in the last two years. Frequency of data breach attacks rose by 125% since 2010. However, about 30% of medical identity theft victims don’t know when their medical identity was stolen. MedicFP detects medical identity theft in real time and prevents healthcare fraud with ease. This healthcare fraud prevention solution gives payers and providers the confidence of knowing that they are treating the correct individual, while protecting patients from the devastation that comes with a data breach.

Prevent Patient Harm from Medical Identity Sharing

Medical Identity Sharing

The third kind of healthcare fraud that MedicFP prevents is medical identity sharing. This is one of the most controversial aspects of healthcare fraud. Medical identity sharing is most often committed between family members or friends who want to help their loved ones avoid high costs of care. Even more concerning than financial loss is the impact on human life. If a patient’s medical identity is shared, then medical professionals won’t have accurate, potentially life-saving information. Both people involved in medical identity sharing are risking their health and their lives. MedicFP’s solution prevents this potentially fatal form of healthcare fraud.

Prevent Healthcare Fraud Before Treatment

Because our healthcare fraud prevention solution takes place before services are rendered:

  • patients are safe from the costly and dangerous burden of identity theft
  • medical professionals have up-to-the-minute, accurate patient identification so that services and medications benefit the correct individual
  • payers immediately eliminate fraud in their network, saving billions annually

According to the Department of Health and Human Services, hackers breached more than 100 million health records in 2015 and that number hasn’t improved. Even though 2015 was the worst year in history for data breaches, there has not been a strong response to the need for data security. With MedicFP, medical providers, insurance companies and government agencies can focus their resources on the greater good: on continuing to help improve people’s lives.

MedicFP’s mission is to disrupt fraudsters and protect payers from the crippling cost of healthcare fraud through prevention of phantom billing, medical identity theft and identity sharing.