“ScanWriter’s advanced data entry automation and automated data visualization of the flow of funds assisted investigators to quickly uncover a $150 million healthcare fraud scheme.”
Manual methods of capturing, normalizing, and analyzing data have left government investigators far behind fraudsters and have increased the number of backlogged cases.
These investigators need advanced tools like ScanWriter to automate the data entry, which would increase productivity and reduce the time it takes to complete a case. In fact, ScanWriter can reduce the data input time from months to weeks.
In this case study, a government office was successful at investigating a medical fraud case in a comparatively much shorter period after adopting automated solutions to reduce their backlogs.
Putting a Stop to Misuse of Taxpayers’ Hard-Earned Money
A pharmacist pleaded guilty to participating in a healthcare fraud scheme that resulted in more than $150 million in fraudulent claims being submitted to federal healthcare programs.
The scheme involved the prescription and distribution of unnecessary compounded medications and the submission of false and fraudulent claims to Medicare and TRICARE.
Authorities sought assistance from ScanWriter to effectively investigate and prosecute this complex fraud scheme. Investigators were frustrated with the limitations of OCR readers and the need for additional software tools to fully utilize their functionality. ScanWriter provided a more accurate and efficient solution.
ScanWriter is a powerful SaaS tool designed to assist investigators in uncovering fraudulent activity. ScanWriter offers a range of features and functions, including the ability to analyze large amounts of data, identify patterns and anomalies, and generate reports and visualizations to help build a case.
Investigating healthcare fraud was not new for the agency. However, Scanwriter was undoubtedly a unique solution that officials used for investigating the case.
The solutions that officials had used before ScanWriter had many shortcomings, like inaccurate capture of data, the inability to read financial statements in bulk, and the inability to automatically populate data visualizations for following the money.
Adopting a new tool is never easy, but ScanWriter’s professional customer support team assisted the officials with a smooth onboarding process and rapid adaptation of the tool.
For instance, during the investigation, officials needed to process financial statements from a small-scale credit union. ScanWriter’s development team was able to add a new reader in less than 48 hours, enabling officials to capture financial data very quickly.
One of the officials needed assistance to add additional data filters to the Flow of Funds visualization model while tracing the assets. A ScanWriter support team member assisted the official on a call until they could easily understand the functions of the Flow of Funds visualization that is automated through ScanWriter.
Eventually, ScanWriter was able to help authorities build a strong case against the pharmacist and others involved in the fraud scheme.
Empowering Anti-Fraud Professionals in Public Sector with Advanced Tools
The pharmacist’s fraud scheme was highly sophisticated and involved the prescription and distribution of unnecessary compounded medications to patients.
Compounded medications are typically customized mixtures of drugs that are not commercially available and intended to meet individual patients’ specific needs.
In this case, however, the medications were prescribed and distributed without a legitimate medical need, and the claims submitted for payment were false and fraudulent.
Investigating and prosecuting a case of this magnitude presents numerous challenges for law enforcement and other authorities.
The sheer volume of data in such a case can be overwhelming, and sifting through that data to uncover evidence of fraudulent activity can be time-consuming and labor-intensive.
Additionally, the complexity of the fraud scheme and the number of individuals involved can make it difficult to build a strong case and secure convictions.
Luckily, agencies can empower officials with advanced tools and techniques to investigate fraud cases. By automating the data entry process, these officials can eliminate administrative tasks and devote their precious time to more meaningful work of uncovering fraudulent activity.
Disclaimer
Specific names of entities have been omitted in this case study for confidentiality reasons.
About ScanWriter
ScanWriter is a data entry automation and visualization tool that assists in financial fraud investigations. It is a homegrown software trusted by many district attorneys, forensic accountants, and fraud investigators across the US working in the public sector. ScanWriter takes pride in offering 100% accuracy, exceptionally high processing speeds, a built-in audit trail, automatic visualization of financial models like ‘Flow of Funds,’ easily-accessible customer support, and more. ScanWriter creates opportunities for anti-fraud professionals to focus on more critical tasks to fight financial fraud, meet deadlines, maintain data integrity, and provide deeper data analysis.
About Personable Inc.
Personable Inc. is a privately-held software company founded in 1998 with headquarters in Fountain Valley, California. We provide solutions to automate the data entry workflow. Our company is committed to serving private and public-sector professionals nationwide.