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H.E.A.T.™ (Healthcare Enforcement Action Team)

Long before the 2017 fraud reforms, the robust H.E.A.T. proprietary database has been cataloging and supplying accurate information to support anti-fraud initiatives. H.E.A.T. tracks provider qualifications, uncovers counterfeit identities, and links potential financial interest relationships of other providers creating a causal flow diagram for investigators.

H.E.A.T. 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, H.E.A.T. is ammunition that powers up your SIU program to capture and prevent abusive and fraudulent medical practices.