Spotlights > Medicaid Fraud
Medicaid Fraud
Protecting New York State Counties and Taxpayers
To uncover fraud or abuse, counties throughout New York State are turning to TBG to perform operational, policy compliance, billing, and medical necessity audits of selected laboratories, pharmacies, transportation companies, and physicians receiving reimbursement from their Medicaid programs. TBG has a well-qualified team of auditors, compliance experts, medical review staff, and investigators who have experience with Medicaid, compliance, and claims auditing.
TBG performs Medicaid regulatory documentation audits for compliance, provider claims audits, and Medicaid program contract audits. We have many years of utilization review and claims adjudication experience from the viewpoint of the insurance industry, specifically, disability, health maintenance organizations, and the independent physician association, and we also partner with insurance carriers and attorneys to conduct comprehensive utilization reviews of provider claiming patterns.
For more information on TBG's Medicaid Fraud services, call us at (800) 487-7624 or contact us.
