It’s no secret for today’s health care provider that investigators from regulatory boards, insurance companies and law enforcement agencies are on the prowl looking for providers who are not following the laws & rules – with a major focus on health care fraud!


And, these investigators, especially law enforcers, are particularly interested in finding health care providers engaged in health care fraud and establishing the evidence to prosecute providers who 1) billed for services not rendered; 2) billed for services that misrepresent the nature of the services provided; 3) billed for substandard and/or unnecessary services; and/or 4) billed for services that misrepresent the actual service provider.


Law enforcement agencies, even the Fed’s, have limited resources that prohibit them from investigating every provider on whom they receive information alleging health care fraud.


How do fraud investigators maximize their resources, and enhance probabilities for successful health care fraud prosecutions? They search for easy targets!


They don’t have to search far! What is an easy target you ask?



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