You can help prevent Fraud, Waste, and Abuse (FWA) by doing all of the following.

You can help prevent Fraud, Waste, and Abuse (FWA) by doing all of the following.

• A. Look for suspicious activity
• B. Coordinate with other payers
• C. All of the above
• D. Verify all information provided

Answer: (C)

Preventing FWA relies on a mix of vigilance, collaboration, and verification. Looking for suspicious activity helps you catch red flags early—unusual claim patterns, duplicate bills, improbable services, or providers with risky billing histories. Coordinating with other payers broadens visibility beyond your own data, making it possible to spot patterns that span plans, such as a provider billing multiple insurers for similar services or a patient receiving the same service from different providers. Verifying all information provided ensures claims are accurate before payment by confirming patient identity and eligibility, dates of service, medical necessity, and supporting documentation. Because each step addresses a different aspect of risk, using all three together gives the strongest protection against FWA.

Preventing FWA relies on a mix of vigilance, collaboration, and verification. Looking for suspicious activity helps you catch red flags early—unusual claim patterns, duplicate bills, improbable services, or providers with risky billing histories. Coordinating with other payers broadens visibility beyond your own data, making it possible to spot patterns that span plans, such as a provider billing multiple insurers for similar services or a patient receiving the same service from different providers. Verifying all information provided ensures claims are accurate before payment by confirming patient identity and eligibility, dates of service, medical necessity, and supporting documentation. Because each step addresses a different aspect of risk, using all three together gives the strongest protection against FWA.