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- Healthcare Fraud, Waste, and Abuse | CLEAR
Utilize critical data sources to fight fraud in your programs
Each year, instances of healthcare fraud cost the U.S. Government tens of billions of dollars. As technology continues to advance and change, strategies to defraud healthcare programs become more sophisticated, increasing associated costs. Therefore, health and human services professionals and investigators need a solution that helps to investigate and uncovers critical data points that other resources miss. Thomson Reuters CLEAR combines countless data sources to streamline your workflow, uncover potentially unknown details, and help your agency identify fraudulent activity other investigative tools may never even see.
What you get when you use CLEAR to identify healthcare fraud, waste and abuse
Connect to live-feed data including real-time records, phone numbers, addresses, social security numbers, relatives, businesses, and more.
See where and when data came from to feel confident you are referencing the most current and accurate data during searches.
Select your own features and data inclusions to view results, reports, dashboards, and alerts that matter most to you.
Interact with results highlighting connections between individuals, businesses, and aliases that might be enabling fraud, waste and abuse.
Search thousands of subjects and businesses in seconds, finding results that fit your schedule, budget and agency requirements.
Access professional licensure, National Provider Identifier (NPI), and sanction records from all professional healthcare taxonomies by state.
Why trust CLEAR
Provider fraud
Prevent provider fraud within programs
Fraud, waste and abuse committed by healthcare providers is a growing trend resulting in billions of dollars of loss to government programs and beneficiaries. With tens of thousands of providers offering treatment and services, it’s easy to see how criminal and fraudulent activity can go unnoticed by Program Integrity professionals.
How CLEAR helps
Creating repeatable processes to evaluate vendors means you and your agency can be better protected from fraud. CLEAR allows you to automate and customize your risk analysis and vendor assessment to fit your unique decision-making requirements, enabling your team to move faster and act confidently in making decisions. It also shows you any potential risks from your vendors relatives and associates – allowing for a deeper dive to see if any adverse people or businesses are connected to your vendor.
Opioid epidemic
Fighting the opioid epidemic
Daily, reports surface regarding the impact of opioid incidents on families, and the associated costs on Government agencies. You need trusted resources that can help identify prescribers who may be overprescribing and conducting pain management fraud – protecting the communities you serve.
How CLEAR helps
Thoroughly investigating suspected or reported fraud, waste and abuse takes time and resources. CLEAR delivers you with trusted personal and professional records to look into past criminal history, fraud activity, or program and patient abuse. This means you can be more confident you are finding new information to continue your investigation.
Identity verification
Determine validity of identities
As identity theft and financial fraud continue to grow, government program risk increases with the wide span of programs and perceived loopholes by fraudsters. Even using a small fraction of a real identity, fraud, waste and abuse against programs using synthetic identities creates new issues for Program Integrity professionals.
How CLEAR ID Confirm helps
CLEAR ID Confirm is a fully customizable solution designed to validate that an identity of a beneficiary exists, enabling agencies to prioritize investigations for identities that may be falsified.
Vendor risk
Manage vendor risk
Whether buying office supplies or reviewing vendors and businesses for large procurements, who your agency does business with creates risk for fraud, both intentional and unintentional. Completing the due diligence on the business and associated individuals is burdensome.
How CLEAR helps
Creating repeatable processes to evaluate vendors means you and your agency can be better protected from fraud. CLEAR allows you to automate and customize your risk analysis and vendor assessment to fit your unique decision-making requirements, enabling your team to move faster and act confidently in making decisions. It also shows you any potential risks from your vendors relatives and associates – allowing for a deeper dive to see if any adverse people or businesses are connected to your vendor.
Thomson Reuters had the highest rate of identifying the beneficiary in their system, and had the highest match rate with the successfully delivered certified mailings all while providing the most cost-effective solution for this top oversight initiative within CPL.
Having access to information all over the country is invaluable to us in our line of work. Most of the other resources we have are local which really limits our ability to locate people.
Thomson Reuters products not only help make the world a safe, more secure place, they can also enable government agencies to locate individuals to ensure they receive timely disability benefits that are due.
Advanced CLEAR capabilities
CLEAR ID Confirm provides configurable identity verification for providers, beneficiaries and vendors through an array of current data to see if identities actually exist.
For large-scale data work or investigations, Batch volume searching identifies current information from the CLEAR public records databases for individuals and businesses.
CLEAR data can integrate into customized workflow solutions through an Application Program Interface (API), keeping your familiar, internal system, but increasing your data value.
Quickly review risk indicators such as arrests, bankruptcies, redundant SSNs, synthetic identity, and more across state and federal criminal jurisdictions.
Thomson Reuters is not a consumer reporting agency and none of its services or the data contained therein constitute a ‘consumer report’ as such term is defined in the Federal Fair Credit Reporting Act (FCRA), 15 U.S.C. sec. 1681 et seq. The data provided to you may not be used as a factor in consumer debt collection decisioning, establishing a consumer’s eligibility for credit, insurance, employment, government benefits, or housing, or for any other purpose authorized under the FCRA. By accessing one of our services, you agree not to use the service or data for any purpose authorized under the FCRA or in relation to taking an adverse action relating to a consumer application.