Amid the challenges of providing care throughout the pandemic, telehealth has become a path through which patients can get the help they need with increased convenience and without exposing themselves to COVID-19. Payers, providers, and regulatory agencies worked together to help ensure that those in crisis would have access to the services they needed throughout the pandemic. However, as we navigate the present, payers should consider how these pandemic changes are affecting behavioral health claims today.

As the industry has continued to navigate the historic influx in behavioral claim volume, bad actors have been exploiting new possibilities within fraud, waste, and abuse (FWA). And as changes have been made to increase access, these bad actors have seen these added flexibilities as an opportunity for FWA.

In this white paper, we will:

• Walk through the changes that have been made throughout the pandemic
• Examine where weak points exist within behavioral healthcare claim payments
• Explain how plans can both safeguard themselves and be confident in their own claim accuracy