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SPEAR
Long before the 2017 fraud reforms, the robust SPEAR proprietary database has been cataloging and supplying accurate information to support anti-fraud initiatives. SPEAR tracks provider qualifications, uncovers counterfeit identities, and links potential financial interest relationships of other providers creating a causal flow diagram for investigators.
SPEAR collates, among other things:
• Non-qualified providers
• Licensing gaps
• Drug Enforcement non-compliance
• Billing and coding violations
• Mischaracterization of actual services rendered
• Prohibited self or cross referrals
• Other fraudulent or abusive practices
From MPN provider vetting to claim strategy defense, SPEAR is ammunition that powers up your SIU program to capture and prevent abusive and fraudulent medical practices.
