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Online Update on Insurance Fraud Spring 2010
 

Notes From the Editor

Brent Walker

IASIU News Spring 2010

Welcome to IASIU’s second edition of SIU eNews. In this issue you will find that our IASIU chapters have been very busy with antifraud training and networking. You will also find a new section called, “Ask the Expert”. This column will allow you, the SIU eNews reader, to pose relevant antifraud questions to industry experts through SIU eNews in a Q&A interview format. We hope you enjoy this issue’s “Ask the Expert” section on MRI Diagnostic Testing and Questionable Claims, certainly a hot topic. We’d also look forward to hearing from you about antifraud questions that you would like to learn more about in future issues of SIU eNews “Ask the Expert”.

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Featured Article

Ask the Expert - MRI Diagnostic Testing and Questionable Claims

As insurance fraud investigators, we have certainly seen an increase in the utilization of MRI diagnostic testing and their association with a growing number of questionable claims. To learn more about what we as investigators should look for when faced with MRI billing on a questionable claim, SIU eNews interviewed Dr. Mark A. Doyne, MD, FAAOS, FAADEP, FACPE, medical director of MES Solutions and board certified orthopedic surgeon.

SIU eNews: What is an MRI and how does it work?

Dr. Doyne: MRI stands for Magnetic Resonance Imaging and has been available since the 1980’s. A plain x-ray only allows us to see things like bones and soft tissue shadows.

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Featured Article

Investigating with Social Media

Snapshots on Anti-Fraud Training

by James Ruotolo

There is no question that social media has experienced exponential growth. The Pew Internet & American Life Project reports that 46 percent of all American adults use at least one social networking site, up from 8 percent only five years ago. With the swell in user-generated content housed on social media sites, it’s no surprise that investigators turn to them when conducting background investigations.

Last October, the Secret Service was able to locate fugitive Maxi Sopo hiding in Mexico when he updated his Facebook status.

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IASIU News

Spring 2010

The IASIU January MAD (Membership Acceleration Drive) has been a huge success. About 700 new members have joined IASIU, and that was a surprising and overwhelming response.

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Chapter News

 

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