Mitchell Launches Provider Data Tool to Combat Fraud, Waste

Thursday, October 8, 2020 | 0

Mitchell, a provider of technology services for property and casualty insurers, said it launched a new tool tracking data about providers that it says can help identify irregular activities and reduce fraud, waste and abuse.

The company said in a statement that its Provider Data Explorer allows workers’ compensation claims organizations to analyze provider treatment and billing behaviors. The program tracks metrics including treatment duration and frequency, billing and adjustment behaviors, and use of procedure codes that can drive up invoices.

“By providing visual depictions of claims data, the visualization tool compares medical provider behavior to that of their peers,” Mitchell said in a statement. “Users can see provider peer-to-peer comparisons that can be used in a variety of ways, including easily pinpointing outliers in order to help identify potential fraudulent or abusive medical provider treatment or billing behaviors for investigation.”

Mitchell also said the software can be used to validate charges from providers and to help claimants find treating physicians.