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Fraud › Reimbursements › Insurance Claims

Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain. 
Davis Wright Tremaine LLP

Anthem's New Chargemaster-Based Claim Edits: Which Charges and Providers Will Anthem's New Process Target and How Will It Impact...

Davis Wright Tremaine LLP on

Effective August 1, 2025, Anthem will implement a new claims-editing process that adjusts payments for Medicare Advantage (MA) claims based on an undisclosed, customized chargemaster table. The announcement identifies claims...more

Ervin Cohen & Jessup LLP

Companies That Pay Hackers May Be Able to Recoup Their Losses

Ervin Cohen & Jessup LLP on

Where companies are victimized by ransomware or email scams, their losses arise from payments made by an officer or employee of the company. In the case of ransomware, a company’s files are held hostage pending payment...more

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