Flavors of Fraud, Abuse and Waste Blatant fraud has many names. Sometimes claims are submitted for services that never were rendered.
Fraudulent behavior is a deliberate intent to mislead.
Abusive or wasteful practices are not as easy to identify. Abuse and waste involve the question of medical necessity. As a Watchdog Using advanced technical solutions, health care entities are creating formidable lines of defense against fraud. This group of technologies uses databases with robust query tools, algorithms, and other statistical identification techniques such as artificial intelligence to transform raw data into usable information. The potential return on investment in these systems is significant.