Medicaid Fraud and misappropriation result in losses of billions of dollars each year depriving benefits from people who are truly in need. Antiquated systems, manual processes, poor data visibility and disparate data, influx of cases and personnel employee budget cuts increases the challenges that exist at CMS and Medicaid Fraud Control Units in identifying and investigating fraud.
Column Case Investigative offers a collaborative, integrated, web-based software solution that helps agencies manage Medicaid complaints and cases. Focused on state and federal requirements, Column Case Investigative offers collaboration, content management, workflow automation, and integration features you need to improve case management.
Our solution has been built to investigate:
- Fraudulent Billing
- Substitution of generic drugs
- Unnecessary services performed
- Kickbacks
- Reporting
- Wrongful Coding
- Unbundling
- Identity theft/Use of provider numbers
- Upcoding
With Column Case Investigative for Medicaid Fraud, you will be able to:
Replaces paper-based case folders with secure, case-specific virtual workspaces. Users can coordinate their work and manage unstructured content such as Microsoft Office and PDF documents, HTML files, e-mail messages, images, forms—even audio and video files to improve record, document, and evidence management.
User and group-level security allow complete audit trail and promote information sharing and fulfill your organization’s responsibility to protect privacy.
Powerful data quality management tools use business rules and real-time logic to validate, cleanse, and integrate data. The result? Accurate, timely, and complete information that supports good decision making without compromising speed and efficiency.
When you need to find information, you can securely search external data such as documents, web pages, attachments, forms, and activity logs. The search capability is performed through a Google® type search bar. You also have access to Column's powerful data visualization tool to help you uncover relationships among data elements.
Built on the most powerful workflow engine used by over 80% of the Fortune 500 including the US Department of Defense, Column Case Investigative can automate manual, time-intensive activities while ensuring security and role-based access. Workflow rules can mirror your current practices by sending notifications or information, creating or escalating assignments, requesting approvals, and updating data fields. Whether you automate one process or all of them, you’ll eliminate redundant tasks, reduce errors, speed approvals, and ensure compliance.
Powerful reporting and dashboard consoles provide real-time performance metrics and fully integrate with a wide variety of business intelligence solutions. The solution provides business intelligence by including a large number of standard reports and dashboards as well as the ability to create custom reports and ad-hoc queries. If rolled-up data demands an explanation, you can easily drill down for more detail.
Column Case Investigative allows agencies to quickly determine what cases have a high solvability factor or high priority through automated solvability scoring. A must-have feature for Medicaid Fraud Control Units to help dramatically increase the number of cases that can be prosecuted or settle and the dollars the department recovers.
CIO