Fraud costs employers millions each year.
Zenith’s Special Investigation Unit takes a proactive stance against fraud.
Our Special Investigation Unit (SIU) is staffed with trained investigators, many with years of law enforcement and prosecution experience. Claims where employees have lost time from work are screened by our SIU for potential fraud or abuse. Zenith’s goal is to find the truth—either by validating an injured worker’s claim or building a case against possible fraud or abuse. Knowing the red flags of fraud is one way to identify suspicious claims. While not proof of fraud, red flags identify activities that historically have proven to be indicators of fraud. Visit www.TheZenith.com/redflags to learn more. |  |
Zenith also employs a Complex Case Analytics Team (C-CAT). C-CAT investigates medical provider fraud and abuse, a major factor in today’s escalating medical costs. They focus on provider fraud in the following areas:
- Doctor dispensed medications and pharmaceuticals
- Fraudulent upcoding and billing over fee schedule
- Unlicensed medical providers
- Unlicensed transportation companies
- Patient brokering (capping)
- Interpreting firms
- Other ancillary services associated with workers' compensation claims
