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About The Client

This client is a Covid testing lab that has done more than 1.5mm tests and needed a comprehensive audit to make sure they are compliant to receive Medicare payments. They received more than $200mm in payments and needed a comprehensive audit on nearly 1,000 locations. The main things they wanted to audit were:

  • Comparing internal vs external records
  • Audit Excessive Use of Addresses
  • Audit Excessive Use of Phone Numbers
  • Audit Excessive Use of Email Addresses
  • Audit IP Address Location
  • Visualize Results 

Key Strategies Implemented

  1. The main strategy here was to take their existing reports and recreate them in PowerBI.
  2. From here, we worked closely with compliance experts and then audited the labs data based on the experts criteria.
  3. Using advanced Excel modeling and the DAX functionality in PowerBI, we could detect fraudulent claims and export the data to meet the client’s objective 
  4. The next step was to visualize the data and create automated reports using PowerBI and Excel
  5. Lastly, the client wanted spot checks to maintain data integrity.

1,500,000+ Covid Test Claims Analyzed

Found Up To 25% Fraud From Certain Locations

Client Maintained Compliance

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