System launched to detect Medicare fraud

Blue Cross and Blue Shield United of Madison, Wisconsin has developed a new computerized Fraud and Abuse Management System (FAMS) that detects patterns of fraudulent behavior in provider Medicare claims.

BCBS United of Wisconsin is one of Medicare’s largest claim processors, reviewing more than 8 million Medicare claims annually from across the country.

The new FAMS system works in conjunction with Medicare’s own internal fraud detection squad by using billing data and ranking systems to compare providers’ behavior with their peers.