Case management software is the most reliable way to track healthcare dos and don’ts.
What does that entail? Here’s a rundown ...Do strongly consider the benefit of software that offers a robust response to fraud, which is extremely damaging to our healthcare system:
- Tens of billions of dollars – that’s what healthcare fraud costs each year, according to the FBI and the National Health Care Anti-Fraud Association.
- It doesn’t matter if you buy your own insurance policy or you go through your employer for insurance, healthcare fraud affects everyone by translating into higher premiums and out-of-pocket expenses for the insured. Fraudsters also reduce your benefits and coverage.
Don’t forget that healthcare fraud is more than a financial crime. The state of our healthcare system is problematic because of an excess of response to basic problems.
Overkill vs. Actual Fraud
It can be difficult to tell the difference between overkill and actual fraud. Here’s just one of an avalanche of reports detailing the problem:
The researchers called it “low-value care.” But, really, it was no-value care. They studied how often people received one of twenty-six tests or treatments that scientific and professional organizations have consistently determined to have no benefit or to be outright harmful….
Millions of Americans get tests, drugs, and operations that won’t make them better, may cause harm, and cost billions.
Extremely invasive yet unnecessary surgeries often have lasting and harmful consequences. Expensive CT scans and other forms of imaging that rely on radiation are thought to be a driver of increasing cancer rates.
Do keep in mind the hippocratic oath when seeking case management software, which can help fight the problem of fraud in the industry. Consider software that is a proven solution for some of the world’s largest healthcare agencies and organizations. When researching options, see if you can check the following criteria from the list:
- Can it help you analyze cases to help you determine actual fraud?
- Does it provide an end-to-end solution for each and every member in the investigation and discovery chain?
- Does it allow case managers to record and manage incidents and documents, analyze case data, uncover related fraudulent case?
- Is the software you’re considering flexible and accommodates many different organizational structures?
- Does it feature permission-based access allows case managers, investigators, and auditors to communicate and stay organized?
More Dos and Don'ts
Don’t try to save money by circumventing the initial cost of investigating fraud and putting the work on your IT department, and other employees.
Most employees have plenty on their plate without adding an extra project that can be efficiently helped along by case management software.
Do reduce time-wasting errands for your team members, including emails, phone calls, faxes, sticky notes and administrative tasks.
Do utilize software that legitimately counteracts the billion dollar industry of healthcare fraud, which ultimately affects all U.S. citizens.
Do benefit from real-time, customized reporting and much more.
See how case management software can revolutionize your office.