Social Security has posted a "Request for Information" seeking "sources capable of providing a commercial off-the-shelf (COTS)
software solution designed to help detect and analyze sophisticated
cases of fraud, waste, and abuse."
Because, of course, such "sophisticated cases of fraud, waste and abuse" must exist and it must be possible to find them using a computer program.
8 comments:
Maybe it will detect BS CE's? ;)
Justin
If you all would document the record well enough, there would be no need for CE's. Had a 12 y. o. kid case with one medical exhibit and it was our CE. Rep was amazed it wasn't paid. No documentation of medical care anywhere. Why waste the judge's time??
They seem to "detect" just find, I think they should be seeking the brass globes to "act" on what they "detect"...
I'm sure there are some medical providers who could be rooted out, especially if you start comparing where a person lives to the provider. It's always strange when a claimant's medical records are a doctor who is 30 miles away and nearly all of a rep's clients go to that doctor instead of the physicians much closer to home.
@ 10:22 AM In relation to the case you are referring with one exhibit, was there any indication that there were sources whose records were not contained in the file? Or was it a situation where the child just had no treatment?
If it is the first, then it was the reps fault for not documenting the file. If it was the second, what would you have the rep do? We cannot document with records that do not exist.
And why is a case with a single exhibit necessarily a waste of the Judges time. It would certainly seem to depend on what that one exhibit established.
This is because we assume any individual who has medical problems would actively seek help in order to correct said problems. No insurance is certainly a possible answer but there is a large majority who qualify for medicaid but still seek to find medical assistance.
Another of SSA's waste of public funds. First they waste resources by paying employees to form a work group to brainstorm the idea of asking non-governmental sources to provide the agency with what it needs. The work group participants impress agency officials by using acronyms such as COTS. Agency officials respond by giving the work group participants extra bonuses for taking time off from their regular work to come up with the idea of asking someone else to provide the agency with what it needs. Seriously, if it's off-the-shelf software, why not just buy it?
Wow you are all missing the obvious, MYSSA fraud, how else you going to prevent this. Who cares about DIB fraud or SSI Fraud, Lets talk about redirected check via MY SSA
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