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Negotiated Review & FRAUD & ABUSE:

Insurance fraud costs the insurance industry nearly $100 billion dollars per year. MCCI's anti-fraud program is another way in which we will partner with you to safeguard against unnecessary and inappropriate medical and chiropractic care rendered and charged. By using a three-step process, we are able to identify, establish and report unscrupulous activity. We first identify potentially fraudulent or abusive medical coding analysis, then establish severity on injury or loss sustained by claimant and finally, provide a complete, concise, and easy to read report of findings. MCCI’s anti-fraud program is just another way we are working to decrease our clients’ expenses and identify claims that should be forwarded to their Special Investigations Unit and/or to the State for further investigation.