The New Standard
in Data Analytics and Prevention
Use SGS to prevent Fraud, Waste and Abuse in your program.
24
Years of Experience in Fraud Waste and Abuse
SGS Protects
We Take Pride In Our Numbers
77M
Millions of Beneficiaries Covered by SGS
561,000
Number of Providers
22
States and Territories
Served by SGS
15
Years of Experience
10K
Business Partners
25M
Products Installed
22
Countries World Wide
5
Industry Awards
54%
Percent of Inappropriate dollars saved Preventative
39%
Percent of inappropriate dollars saved Recovered
7%
Percent of inappropriate dollars saved Revocations
Let our Solutions Protect Your Program
When you work with SafeGuard Services LLC (SGS), you work with a team that is:
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Effective – SGS effectiveness has allowed the organization to grow to become one of the largest contractors addressing fraud, waste and abuse for Centers for Medicare & Medicaid Services (CMS).
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Secure – The data being analyzed is highly protected. The SGS Security program is based on the National Institutes of Standards and Technology (NIST) 800-53 security controls to allow SGS to conform to requirements for federal systems, auditable under the Federal Information Security Management Act (FISMA).
Medical necessity review is performed by a highly skilled SGS clinician who considers rules and policies as well as standard medical practices in evaluating the services performed and claim billed.
SGS applies over 24 years of experience in FWA to promote loss prevention by recommending enhancements to payment systems, to proactively pay claims correctly, and minimize future overpayments.
SGS data analysts and statisticians apply a wide range of detection capabilities, including predictive modeling and complex data mining
SGS Investigators substantiate the allegations by analyzing associated records. Desk-level investigations include analyzing information about a subject such as enrollment, claims, and other background data.
Unprecedented capabilities. Impeccable reliability.
Our experience with fraud and abuse analytics has resulted in the referral of thousands of cases to law enforcement and resulted in successful criminal and civil prosecution and civil monetary penalties. Benefits of the program safeguard services offered by SGS include:
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Increased profitability through recovery of past overpayments and through mitigation of future fraud, waste, and abuse loss
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Ability to conduct predictive analysis to support investigations
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Reduced risk of predatory attacks through strengthened policies and enhanced use of automated prepayment protection
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Reduced risk of adverse publicity and increased potential for positive publicity regarding proactive approach to address fraud, waste and abuse
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Collaboration with stakeholders on approach and preventive measures
