SIU Support Services

• Data Validation
• Claim Audits
• Evidence Documentation
• Litigation Support
• Expert witness testimony
• Preparation of case for litigation
• Site Inspection
• Education
• Litigation Strategy Consulting

SIU Support Services Include:

• Data Validation
• Data Analytics
• Fraud Detection in Coding, Billing, Care Management, Documentation
• Complex and High Cost Claims Audits
• Medical Necessity Evaluation
• File preparation for Litigation / Evidence Gathering
• Site Visit Evaluation / Provider Interview / Education
• Case Coordination with SIU / OIG / DOJ
• Litigation Strategy Development
• Recoupment Assistance

Data Analytics Validation:

• Validate data analytics to ensure that data is clean and correct
• Point out areas of vulnerability
• Obtain Evidence to recoup or prosecute

Fraud Scheme Detection:

• Trend in care management fraud scheme
• Professional and licensing analyst. Identify licensing issues
• Business network analysis to detect organized fraud

Education and Training

• Education and training for the SIU team, providers, claim management staff, providers, OIG / DOJ / DA
• Education and training in clinical documentation
• Education and training in compliance
• Education and training in Program Integrity