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Putting a stop to medical billing fraud

On Behalf of | Sep 27, 2022 | Medicare / Medicaid Fraud

As technology for billing and tracking medical expenses has increased in ease and sophistication, challenges still exist for outsourcing companies in the business of billing. Patients have unprecedented access to their digital health records and can track health care expenses and locate possible billing errors.

Fraud continues to be a significant and ever-growing problem as providers in the medical billing outsourcing market with improper coding. Medical billing outsourcing companies find it hard to keep up with skyrocketing fraudulent activity.

Startling statistics

A study conducted by SkyQuest conducted an analysis of more than 1,200 responses from companies experiencing fraud over the course of 12 months. Forty-eight percent reported acts of fraud during that time. The most startling statistic is medical providers being the most likely of all companies to be victims of fraud.

The need for stronger fraud prevention is of paramount importance. Medical billing providers are increasing investments in various fraud prevention measures, including database analytics and risk management tools. A specific focus will be on employee training. Implementation is likely by 2025, with companies spending $1 billion, an increase from 664 million in 2020.

Billing providers in the global outsourcing market are realizing that fraud prevention ensures their long-term success, let alone survival. Fraud goes beyond financial losses. A company’s reputation is at stake to remain competitive in the marketplace.

The stakes are high. The medical billing outsourcing market is expected to generate $25.7 billion in sales revenue. Spending a small amount on significantly improved fraud protection can substantially impact both images and bottom lines.