ReconHealth is an innovative, game changing, member centric, and powerful integrity program providing insight, transparency, and accountability into your health care landscape. ReconHealth protects both patients and payers.

Integrity is an industry term that encompasses protection from fraud, waste and abuse. Fraud involves intentional deception and scheming to obtain money or property that belongs to the health care system. Waste is the overutilization of services and practices, directly or indirectly resulting in unnecessary costs to the health care system. Abuse involves unsubstantiated payment for items or services, often when the provider is unaware that such payment has been requested.

ReconHealth addresses all three components of integrity by combating fraud, stopping waste and identifying abuse.

Why we need ReconHealth
There is an enormous need to address the fraud, waste and abuse in health care. Last year, the U.S. spent more than $3.65 trillion on health care. Conservative estimates of health care fraud alone range from 3% to 10% (up to $365 billion) of total national spend. Additionally, combined “waste and abuse” account for 30% of the $3.65 trillion. At stake is at least $1.2 trillion lost annually to fraud, waste and abuse. And spending is growing. National health expenditures are projected to grow at an annual rate of 5.5% through 2027.