Deterring Fraud For
Government-Sponsored Health Plans
Control budgeted healthcare costs and add value to your health plan with help from Castlestone.
Government-sponsored health plans often cover millions of persons serviced by tens of thousands of offices who are authorized to send a claim. Conventional thinking says that oversight is impossible, and authorities must rely on sampling to detect fraud. Castlestone thinks – and has demonstrated – otherwise. Fraudulent healthcare transactions, including invalid prescription and durable medical equipment rental and purchases, increase financial risks and liability for state, and local health plan managers. Because government offices are so stretched monitoring and sampling for the detection of fraud does not always happen. Smaller frauds (under $5,000) are most often undiscovered or ignored, and it costs more to investigate and prosecute. We believe they can be fraud prevented for pennies.
Castlestone can reach nearly 100% of provider locations and get real-time data on encounters-today. No hardware, software or network expenses required. Our monitoring service prevents fraudulent healthcare transactions before the claims are processed. We help you steward taxpayer dollars and gain increased control over your healthcare budget. Every encounter with a provider network of 1,000-150,000 locations can be overseen with today’s payment network infrastructure.
- Proven services and technologies deliver real-time healthcare information from the point of care.
- Transactions are reviewed and flagged for suspicious activity.
- Fraudulent claims are rejected before a payment is ever made, and medical identities are protected from theft.