Coordination with other payers is a recommended practice to prevent FWA.

• A. False
• B. True
• C. Sometimes true
• D. Not applicable

Answer: (B)

Coordinating with other payers is a proactive control in fraud, waste, and abuse prevention. Sharing information across insurers about provider patterns, billing activities, and beneficiary eligibility helps detect schemes that span multiple payers and wouldn’t be visible when looking at one payer alone. For example, a provider who upcodes or bills for the same service across several plans can be identified through cross-payer data analysis, and duplicate or phantom bills become more detectable when claims from different payers are compared. This collaboration also supports quicker investigations and helps stop improper payments, improving overall claim accuracy and program integrity.

While privacy and data security are important considerations—requiring proper agreements and often de-identification—these constraints don’t negate the value of information sharing. With appropriate safeguards, coordinating with other payers remains a recommended practice to prevent fraud, waste, and abuse.