Specialist Service
Fraud, Waste & Abuse Detection
Support for identifying fraud, waste and abuse indicators in radiology and pathology claims submitted to medical schemes.
Verirad helps medical schemes identify indicators of fraud, waste and abuse in radiology and pathology claims. The review process focuses on unusual claiming behaviour, billing discrepancies, duplication and inappropriate utilisation.
Not every irregularity is fraud. Independent review helps distinguish administrative error, waste, over-servicing and cases that may require deeper investigation.
This supports more effective claims governance and protects scheme resources.
Frequently asked questions
What is fraud, waste and abuse in healthcare claims?
It refers to inappropriate, unnecessary, incorrect or potentially dishonest claiming that can increase healthcare costs.
Can Verirad investigate fraud?
Verirad can identify indicators and support claims review processes; formal investigations depend on the scheme's governance procedures.
Why focus on radiology and pathology?
These are specialist, high-impact claims categories where independent review can provide meaningful cost and accuracy benefits.
Contact Verirad to discuss this service.