About the Author
Bill Fox, former Deputy Chief of Economic and Cyber Crime at the Philadelphia District Attorney’s office and a Special Assistant U.S. Attorney in Philadelphia is responsible for executive leadership and vision for the Health Care Insight Exchange Blog.
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Feb
16
The ICD-10 – Fraud Friend or Foe?
Fraud, waste and abuse costs you and I over $700 Billion annually, which equates to almost one third of total healthcare spend. Unfortunately, only about 5 percent of these dollars lost to fraud are ever recovered, mainly because providers have …
Oct
18
Swimming with the Sharks
A remora is a fish that is fairly easy to find. But when you see one you know something else much more dangerous is close by—sharks. One of the more interesting functions of good social network analytics modeling is to …
Oct
11
The Shifting Tide of Health Care Fraud and Abuse
Health care fraud and abuse affects some of the biggest companies and governmental agencies in the country – those with budgets and businesses measured in multi-billion dollar numbers. Ironically the big news headlines seem to always have to do with …
Posted in Fraud, Waste and Abuse, General
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Sep
20
What They Didn’t Know Hurt Them
In the article “Prison Sentence for Insider Crimes,” Tracy Kitten highlights the insidious nature of crimes committed by employees. So much attention is being focused on outside threats—hacking, claims fraud, ID theft—that we tend to slack off our internal monitoring duties.
Posted in Fraud, Waste and Abuse, General
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Aug
17
Back from a short break…sort of
So I’ve been slightly busy the last few weeks travelling for speaking engagements and writing articles. The good news is I’m back. The bad news is…health care fraud is still a serious issue. While on the road the subject most commonly discussed is how can the fight against fraud improve and my answer has remained consistent – deploy better technology.
Posted in Fraud, Waste and Abuse, General
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Jun
27
The Meaning Behind the Numbers and How They Relate to Health Care Fraud
Last week I put out a few key numbers without explaining what they represent. As Promised—this week I am providing the answers!
Posted in Fraud, Waste and Abuse, General
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