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Our approach

Strict policies

We have a zero-tolerance policy when it comes to benefits fraud. Perpetrators will be prosecuted to the fullest extent possible.

Robust systems

We apply rigorous controls when we process claims. We also use machine learning and advanced analytics to track claim patterns, which alert us when something looks suspicious.

Knowledgeable experts

Our dedicated audit and investigation team evaluates claims and looks for atypical claim patterns.

Strong relationships with external partners

We work with health care providers, plan sponsors, advisors and members to prevent and minimize instances of fraud.

We don’t just react to fraud—we take an integrated and proactive approach to prevent it.

Our zero-tolerance policy means that anyone caught committing benefits fraud or abuse will face the proper penalties.

We investigate and pursue all cases of suspected fraud. From fraud education to advanced analytics to trained professionals, we take every step possible to protect your benefits and our integrity from those who seek to commit fraud.