Excellent webcast describes data-drilling for healthcare fraud by Thompson Reuters and XL Health.
Complex, computer driven algorithms described in this webinar scan Medicare and Medicaid databases to look for "patterns of suspicious behavior".
For instance, the famous "ambulance trips to nowhere" are described here.
The take-home message is that fraudsters are finding it MORE difficult to use the healthcare system's inherent complexity to their advantage.
|The data-drilling maps the healthcare providers referral patterns|
What should be apparent after watching this webinar is that the typical physical therapist in private practice is NOT your typical fraudster.
Despite having a these documentation characteristics:
- low adoption rate of Electronic Health Records (EHR) of about 7%
- moderate rate of electronic documentation of 64%
I wonder how we can #SolvePT when we're talking about Medicare Audits?