Solutions – Clinic Investigations

At Kelley Alliance, we have various ways to detect clinic fraud. We perform clinic inspections, clinic surveillance, licensing verification, and medical bill review.

Clinic inspections are a great way to signal to providers that you’re watching their billing practices. In a clinic inspection, a Kelley Alliance investigator will visit the clinic and represent your company professionally and tactfully. We’ll confirm that the clinic is open for business, take note of patient traffic, and verify that the clinic’s licenses are legally displayed and up-to-date.

Our investigators carefully execute:

• Room-to-Room Inspections
• Room Counts and Capacity Checks
• Equipment Verifications
• Medical Record Verifications
• Verification of Patient Signatures
• Driver’s License and ID Checks

We also surveil clinics to monitor their patient traffic. During a surveillance, we’ll record patient descriptions and vehicle license plates so we can match them to patient information. We’ll verify that patients are present and receiving treatment on the days you’re being billed for.

With our thorough investigations, you can be sure you’re not paying benefits for phantom patients or phantom procedures.