Fraud and Abuse

With 28 years of experience working within its own sophisticated, proprietary claims system, A&S has developed a productive fraud and abuse package that monitors data to find the most common abuse of innocent patients burdened with inappropriate medical charges.

The most basic problems experienced with Fraud and Abuse relate to the following edits that are provided, with no additional fees:

• Duplicate paid claims
• Invalid procedures or diagnosis
• E codes as principal diagnosis
• Duplicate primary diagnosis code
• Age Conflict
• Gender Conflict
• Manifestation Codes
• Questionable admissions
• Unacceptable primary diagnosis codes
• Medicare non-covered procedures
• Invalid age
• Invalid discharge status

Experts agree that health Care Fraud could be a 100 billion dollar a year burden on Health Funds, Insurance Companies, and consumers. Why not catch these issues before the money comes out of your pocket?

Why not let A&S save you even more?! It's a no-brainer. We have answers to problems that cost you and your members money.