Public Assistance Fraud Prevention

Enformion for Public Assistance Fraud Prevention

Public assistance is a useful service, but it is also one often targeted for fraud. See how Enformion can help your department to unearth and avoid fraud.

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How Enformion Can Mitigate Public Assistance Fraud 

Public assistance systems help underprivileged people obtain the resources they need to take care of their families and remain healthy.

Although rates of public assistance fraud are relatively low, the resource allocations the programs receive are a target for criminal activity, depriving others of assistance.

Enformion’s services for assisting agencies in preventing public assistance program fraud focuses on beneficiary eligibility and retail vendor suitability for programs such as SNAP and WIC.

Enformion Services for Public Assistance Fraud Prevention

Nonresident Beneficiaries

Some states have better social programs than others, and the variability is an attractant. Enformion’s web application can interactively investigate small numbers of claims while our API gateway and batch file services can securely process thousands or millions of records in bulk.

Once targets are identified, the Enformion web application provides all of the resources necessary to identify any relationships between the applicant and the occupants of the in-state address used.

Dual Participation

Any beneficiaries that are financially struggling may relocate in search of better opportunities, even out of state, if they have to. In that process they may also, unsurprisingly, apply for additional benefits in their new state of residence.   

The resulting dual participation creates an undue burden to taxpayers, whether the duplication is innocent and unintentional or a fraudulent effort to obtain additional benefits.

Enformion’s research application and automated batch processing capability provide a turnkey solution for health agency leadership to quickly mitigate this growing problem.

Deceased and Nonexistent Beneficiaries

While they’re a prominent form of waste, most states make minimal effort to discover and remove deceased and nonexistent beneficiaries from social program rosters. The wasteful cost to taxpayers can be enormous for services like capitated healthcare programs and providing health HMO insurance coverage.

Enformion’s identity verification and management, combined with our deceased audit services, assist government agencies with reducing both of these risks.

Understand Why Fraud Happens

The perpetrators perceive fraud against public services as a “victimless crime.” Circumstances in one’s life can create a feeling of desperation, combined with access to commit the crime, and an expectation that their activity will not be detected.

  • When you know more about risk, you’ll be able to extend help to the people who need it while ferreting out fraud.
  • Risk mitigation tools can help you understand and identify fraud before it even happens, reducing fraud overall.
  • The vendors approved to transact with your program can change over time. In essence, Enformion’s continuous monitoring service will monitor your approved vendor population for adverse changes in their profile, such as a new criminal arrest and conviction, disqualifying their continued participation.

Verify Identities More Easily

Maintain more accurate lists of program beneficiaries. Enformion’s Batch File Exchange services securely provide updated address and telephone information on an interval convenient to the customer.

For claims adjudication, consider Enformion’s identity verification solutions.

Offer Secure Online Options for Public Service

A persistent problem for departments providing public assistance is understaffing. Reaching out to applicants to verify or augment the information provided requires time, and time is money.

Enformion’s API incorporation for third-party web-enabled applications can pre-fill information otherwise needed from the applicant, reducing their effort to review and confirm the information pre-completed.

Expand Services with Confidence

Enformion offers government contract options that provide off-the-shelf access to services in small or large quantities, enabling small pilot programs that scale to meet future needs.

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Talk with a specialist today to learn how Enformion can help to customize a solution that’s right for you.

Call us at 1-855-281-3915, or via online today.