Shane Riedman

Medical provider fraud, waste, and abuse— which have largely eluded most insurers—is an insidious, often unseen, problem that can damage insurers’ margins.

It seems like every month there’s news of another medical fraud bust, often involving rings of various types of providers. But that’s just the tip of the iceberg. There’s…

It’s no secret that medical fraud is a big problem, with some sources estimating the cost at more than $200 billion annually. But knowing the problem is one thing.…

Complex medical bills can make it difficult for adjusters—already overloaded with cases—to find potential fraudulent or excessive billing.