onsistencies between the name of the business and the work performed and significant premium deposits made to avoid audits (“What is Fraud?”). But by far the hardest type of fraud to detect is medical provider fraud. In a phone interview with Allen Beck, a private investigator specializing in Workers’ Compensation Fraud, he detailed some of the easier and harder ways of detecting provider fraud. One of the easier-to- detect signs is an unexplained sudden increase in a provider’s billing and payment levels (Beck). A harder signal to detect is only picked up by more experienced and thorough investigations, and it involves cross-referencing the dates that non-emergency service was performed with office hours, weekends, and holidays (Beck).There are many companies, corporations, and individuals that are devoted to detecting and preventing fraud. Laurie Alden, claims adjuster for Injured Workers’ Insurance Fund, believes that there are certain steps that can be taken to control the amount of fraud. She says that her corporation generally follows eight rules or guidelines: (1) properly train staff about injury reporting procedures; (2) show concern for injured employees; (3) retain current addresses for all employees; (4) educate employees about the company’s position on fraud; (5) listen and document; (6) conduct exit interviews; (7) be aware of unhappy employees; and, (8) participate in active fraud investigation. Also, she states that, “the Special Investigations Unit was successful in saving IWIF policyholders over $3 million in fraudulent claims. In 1997, the Unit met the $3 million figure by mid-year.” Not only is this a testament to the effectiveness of detecting fraud, but it also shows that the number of fraudulent claims is steadily rising. In my opinion it should be a federal law, not just a state law, that businesses carry Workers’ Compensation Insurance for each emp...
