July 20, 2021

In June of this year, a jury found a chiropractor guilty of defrauding health insurers out of $2.2 million by fraudulently billing for services that were never provided, and even went out of her way to issue bogus medical diagnoses, write false prescriptions and bill for fake office visits that never happened.

This is an example of cases that are causing a rise in concern for fraud, waste and abuse (FWA) schemes which are becoming rampant in the healthcare space and costing health insurers nearly 12 percent of their annual revenues, according to recent PYMNTS research. FWA is leading to significant problems that are plaguing claims management, payments and the overall cost of accessing healthcare.

Health insurers have a responsibility...

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