What truly amazes me is the lack of oversight that allows this fraud to go unabated. Doesn’t Allstate, or any company for that matter, have internal guidelines when so many bills are coming from one doctor or facility or facilities. A red flag should be raised when this is happening. Why would it not happen quickly when a certain number of claims are submitted?
sure, some companys have a tracking claims information system. but not all have such great tracking of the bills that come in the door. it’s a delay, pay, peer review for deny the claim.
Now, if they had there own internal Audit Team that would do daily, weekly, monthly and quarterly reports for the company to keep track of these claim reports is the question.
What truly amazes me is the lack of oversight that allows this fraud to go unabated. Doesn’t Allstate, or any company for that matter, have internal guidelines when so many bills are coming from one doctor or facility or facilities. A red flag should be raised when this is happening. Why would it not happen quickly when a certain number of claims are submitted?
sure, some companys have a tracking claims information system. but not all have such great tracking of the bills that come in the door. it’s a delay, pay, peer review for deny the claim.
Now, if they had there own internal Audit Team that would do daily, weekly, monthly and quarterly reports for the company to keep track of these claim reports is the question.