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Politics : View from the Center and Left -- Ignore unavailable to you. Want to Upgrade?

To: Sam who wrote (134808)	3/25/2010 5:43:07 PM
From: Cogito	Respond to of 543041

>>Not that ferreting out fraud isn't important, and plenty of federal and individual company resources should be devoted to that. But--looking for reasons to deny individual claims isn't ferreting out fraud. Fraud that is worth finding is something that individual providers commit, not individual claimants. Providers' fraud is where the really big bucks are, as it happens over and over again.<< It should also be noted that claims are denied for a host of reasons, not just for fraud. Some of the reasons aren't very good ones, and once the providers appeal, the claims are paid. But in a lot of cases, particularly the ones involving reimbursement to clients for bills already paid, there is no appeal. The client simply accepts the denial of the benefit.