Appteon consultants have been involved in addressing Program Integrity in following areas:

  • Prevention–addressing opportunities for improper program administration and use.
  • Detection–implementing measures to identify and mitigate opportunities for improper program use or implementation that are regularly applied to program operations.
  • Correction–executing immediate action to make program repairs if program integrity has been compromised.
  • Prosecution–reporting of abuses to law enforcement officials.

Appteon consultants have in-depth experience of using fraud detection tools like Fraud-X to identify major areas of fraud in insurance and medical claim industry.