A CRI Group investigation to verify hospital bills revealed that the hospital in question was closed almost two years prior due to a dispute amongst doctors — and now existed at a different address, which was 10 km away from the address provided by the claimant.
Further inquiries confirmed that there was no record for the invoice and patient in the given dates (or any other dates). In the course of the investigation, it is also determined that the stamp on the bills is a fake, and the names on the bills are phony.
The case was a lesson to the client to always beware of red flags in the billing process, verify payment and billing information and check all documents for authenticity. CRI Group went on to help the client establish the proper due diligence procedures necessary to prevent and detect fraud.