Client Success
Fraudulent Covid Cases
This client is a Covid testing lab that has done more than 1.5mm tests and needed a comprehensive audit to make sure they are compliant to receive Medicare payments. They received more than $200mm in payments and needed a comprehensive audit on nearly 1,000 locations.
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1,500,000+
Covid Test Claims Analyzed
Found Up To 25%
Fraud From Certain Locations
Client Maintained Compliance
About
The Client
This client is a Covid testing lab that has done more than 1.5mm tests and needed a comprehensive audit to make sure they are compliant to receive Medicare payments. They received more than $200mm in payments and needed a comprehensive audit on nearly 1,000 locations. The main things they wanted to audit were:
- Comparing internal vs external records
- Audit Excessive Use of Addresses
- Audit Excessive Use of Phone Numbers
- Audit Excessive Use of Email Addresses
- Audit IP Address Location
- Visualize Results
Key Strategies
implemented
1
The main strategy here was to take their existing reports and recreate them in PowerBI.
2
From here, we worked closely with compliance experts and then audited the labs data based on the experts criteria.
3
Using advanced Excel modeling and the DAX functionality in PowerBI, we could detect fraudulent claims and export the data to meet the client’s objective
4
The next step was to visualize the data and create automated reports using PowerBI and Excel
5
Lastly, the client wanted spot checks to maintain data integrity.