Insurance companies recover substantial amounts from healthcare fraud investigations
It was announced yesterday that Blue Cross and Blue Shield health plans recovered close to $350 million thanks to a very efficient 2008 anti-fraud investigation. The total money recovered added up to a 43% increase from the previous year. Fraud activities included false claims, improper billing practices and non-covered procedures.
WellPoint – an independent licensee of Blue Cross and Blue Shield – also announced that they recovered $75 million due to waste, fraud and abuse in their system. According to their estimates, for every $1 spent on investigating fraud the company saves or recovers $11.
If insurance companies can find ways to combat waste, fraud and abuse in their systems, Medicare and Medicaid need to find more productive methods. An estimated $68 billion every year – or 3% – of all healthcare expenditures is stolen. The government could insurance millions with that “extra” money.