Research To Identify And Defend Against Possible Insurance Fraud
A Medical Canvass is an in-depth telephone research analysis designed to uncover pre-existing claims and injuries. Medical Canvasses provide an excellent, cost-effective method to determine your Claimant’s medical treatment history.
GII offers various levels of Medical Canvasses ranging from our basic facility checks to our most advanced Premium Plus to meet our client’s needs. We have accumulated a national database of all hospitals, pharmacies, and doctors, therapy providers, radiology centers, and all health care providers allowing our Analysts to perform a geo-targeted area search to find when and where a claimant may have received medical treatment.
Canvassing can assist all lines of insurance associated with any bodily injury claim (Workers’ Compensation, Auto Bodily Injury, Disability, etc.). Regardless of the line of insurance involved, the key point of consideration is that at any time a claimant and/or their attorney may knowingly withhold information pertaining to a claimant’s medical treatment history.
Identify and defend against possible insurance fraud.
- Verify treatment and confirm the alleged date of injury
- Assess in an injury is truly related to the claim
- Discover previous treatment for a similar injury
- Determine if the claimant has a history of prior claims
- Equip you with the knowledge of where and when the claimant has been treated, which can be useful in a deposition
- Bring to light treatment in another geographic location
- Dispute the extent of the injury
- Locate the claimant's primary care physician
- Confirm gym and sports club memberships
- Uncover addictions or drug-seeking behavior with a pharmacy canvass, or even by searching substance abuse counselors and treatment centers
- Determine whether the claimant has a history of depression, anxiety or sleep disorders by requesting a canvass of pharmacies and/or sleep testing centers
- Substantiate or disprove the claimant's complaints and treatment history
At GII, all of our Medical Canvass Specialists are HIPAA Compliant and Certified.
Confidentiality is important in maintaining security and privacy of claimant information.
Breaking the rules of confidentiality by releasing private information to the wrong entity can cause discord, broken trust and possible legal actions. That's why when handling case information, we take it seriously.
For example, claimants often “pick and choose” what medical information is being shared whether it is a 1st party or 3rd party claim. In any case, being able to further validate or discover other medical providers involved in treating the claimant is always going to be critical in evaluating the claim as well as potentially identifying a clearer picture of exposure.
Types of Medical Canvasses include, but not limited to, the following:
Medical canvassing should provide an accurate chronological account of treatment date information. While typically used to reveal unreported treatment, canvassing also allows claims professionals to verify that there may, in fact, not be any other treatment. This thinking is in line with the industry standard of an organization’s right and responsibility to verify legitimate claims and uncover suspicious ones.
GII is able to perform a Medical Canvass analysis of your claimant for any city and state in the USA.