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Program and Benefit Integrity

NCI AdvanceMed helps U.S. Federal agencies reduce improper payments by fighting fraud, waste, and abuse in entitlement programs.

Through our program and benefit integrity solutions, NCI AdvanceMed—an NCI subsidiary—directly supports the Federal Government’s responsibility to avoid wasteful spending. NCI AdvanceMed offers Federal agencies several services that support cost-containment measures through the identification and deterrence of overpayments made as a result of waste, fraud, and abuse in entitlement programs. For Federal agencies seeking innovative, sound practices in reducing overpayments, NCI AdvanceMed offers refined methodologies and best practices in program integrity vulnerability assessments, case management, investigative services, data management and analytics, medical record review, and medical record management. At the heart of NCI AdvanceMed’s suite of services is our progressive data analytics capabilities coupled with our holistic intrinsic investigative mindset. Our investigative team is composed of benefit integrity analysts, fraud investigators, legal counsel, data analysts, and medical review specialists. We use proactive and reactive analytic methodologies and sophisticated tools to stop fraudulent activity before it gets to the entitlement system and to aggressively identify fraudsters who have already made it into the system. Our workforce delivers outcomes that make a difference by reducing overpayments, improving understanding of policy and payment vulnerabilities, containing costs, eliminating backlogs, and improving documentation for case referrals and overpayment recoveries.

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