CareCentrix has partnered with Performant Financial Corporation to offer health care payors stronger mechanisms to identify and decrease waste and fraudulent insurance claims in home health care and durable medical equipment (DME).
Since home health and DME claims are often high-volume but low unit cost, traditional approaches to detecting fraud often fall short and identified opportunities may not be pursued. By leveraging their collective experience in home health care and cost-containment solutions, CareCentrix and Performant will deploy specialized analytics and algorithms to better detect the patterns that are often overlooked but add significant cost to health care payers.
“You only need to look at recent headlines to know that the problems of fraud, waste, and abuse are only increasing in home health care,” says John Driscoll, CareCentrix CEO, in a release. “CareCentrix is committed to bending the cost curve in health care by working with payors to guide care for their members to the home. We are thrilled to expand our capabilities in identifying and decreasing waste and fraudulent insurance claims in home health care and DME, and look forward to working with Performant to stay on the cutting edge of curbing this trend for our clients.”
For more than a decade, Performant has delivered analytics, audit, and recovery services to health care payors. And now, as the cost-containment and management partner to the Centers for Medicare & Medicaid Services (CMS) in the areas of DME, prosthetics, home health care, and hospice, Performant has a view of the national landscape.
“Addressing abuse in high-risk payment areas, including DME and home health care, has become a growing concern among health care payors. We are excited to leverage CareCentrix’s unmatched knowledge of home care management in pursuit of our mutual goal to curb improper payments,” says Simeon Kohl, senior vice president of healthcare at Performant.