Uncovering comp fraud: Where to look first
March 12, 2010 by Christian SchappelPosted in: Communication, Employment law, Health care, In this week's e-newsletter - benefits, Latest News & Views, Money, Pay and benefits
Want to keep workers’ comp fraud from jacking up your insurance rates? Don’t start by looking at injured employees.
Begin by looking at everyone else who touches claims, says Laura Clifford, owner of California-based Employers Fraud Task Force.
In a recent interview, Clifford said less than 10% of the comp fraud her firm’s uncovered was committed by employees.
The other 90% was committed by everyone else (lawyers, adjusters, bill review companies, etc.).
First step to take
What can employers do? One tactic Clifford says cuts down on fraud: Sit down with workers with an explanation of the benefits (EOB) they’ve received and go over it with them.
Reason: If just one injured worker looked at his EOB and said, “I only went to the doctor twice, not five times — like it says here,” then the employer could look at that doctor and see what other patients the doc has seen.
Tags: comp fraud, Employers Fraud Task Force, EOB, insurance rates, workers comp
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