How one health plan is improving its ability to detect fraud and increase recoveries Relationship Mapping unlocks hidden connections and patterns that could expose a health plan to reputational risks, wasteful spending, quality reporting concerns and member safety issues. Doing more with less Ivy Health (not its real name) is a leading private health plan serving members in multiple states. Like all payers, it’s continually seeking ways to reduce fraud, waste and abuse. Recently, management wanted to see if arming its Special Investigations Unit (SIU) with better tools and intelligence, as opposed to adding manpower, could increase its ability to detect fraud. CASE STUDY With relationship mapping, SIUs don’t have to look at the lone wolf. They can look at the wolf pack. They

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