Today’s managed care industry is witnessing a business climate in which billions of premium dollars spent on healthcare are lost to fraudulent and abusive billing practices each year. Of the $3 trillion spent on healthcare annually, the National Health Care Anti-Fraud Association (NHCAA) estimates that healthcare organizations lose at least 3% or $60 billion a year to fraud and abuse. Other estimates by government and law enforcement agencies approximate the loss to be as high as 10% or $300 billion of the nation’s expenditure. Left unchecked, the resulting increases in healthcare costs can lead to benefit cutbacks, increased premiums, and higher out-of-pocket medical costs.
For nearly forty years, PCG Software’s mission has been to help its healthcare payor clients reduce the cost of healthcare by providing software solutions that address these challenges.
