Investigation. Intelligence. Integrity.

The most dangerous risks are the ones you never see coming. That’s where we come in. The Qlarant team is made up of real-world experts who know how to solve complex problems — combining human intelligence and advanced technology solutions to combat fraud, waste and abuse.

We provide a range of services for government and commercial clients, including auditing, monitoring and consulting. Our team is unmatched in experience, investigation and predictive modeling, staying ahead of the industry and ahead of bad actors. Put our investigators and data scientists on your side. Talk to one of our experts.

 

Fraud, Waste & Abuse Solutions

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Pharmacy Solutions

With nearly 20 years of experience, Qlarant brings a wealth of expertise on Medicare Part D and pharmaceutical data analytics.

 

Predictive Modeling & Data Analytics

Qlarant uses proven algorithms and powerful data analytics to sift through billions of records to conduct risk assessments, detect aberrant trends, and alert investigators to potential fraud and abuse.
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Investigations

Qlarant offers proactive and reactive criminal, civil and internal investigations. Our technology solutions identify risks. Subject matter experts know where to look. And “Jump Teams” help find the worst offenders quickly.

Audits

Learn about risks before they become problems. The Qlarant team uses rigorous processes to provide expert onsite audits of risk assessment, compliance, contract, financial, fraud, and performance.

Medical & Claims Review

Qlarant reviews and analyzes records to identify fraud, waste, and abuse, as well as billing, compliance and quality of care issues — protecting your organization and saving you money.

Hearings & Appeals

Qlarant’s renowned subject matter experts develop high-quality fraud case referrals, provide testimony, support appeals effectively and provide thoroughly documented work-products.

Compliance & Due Diligence

Use our compliance experts to help determine an organization’s adherence to industry laws and regulations — and to identify issues or other risks a prospective buyer might inherit.

Enrollment Monitoring & Analysis

Qlarant monitors and analyzes provider enrollment databases, searching for risk factors, investigation data, review findings and more — to identify low- to high-risk providers.

Call Center Management

We provide full-service bilingual call center activities for tracking, trending and investigating FWA issues. Work products are thoroughly documented, secure and readily retrievable.

Communication & Training

Let us train your staff on investigations, audits, and data analysis. We can also create customized training solutions in appeals strategy, medical review, data science and more.
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Unemployment Fraud Solutions

Administrators and directors must constantly innovate and improve on the quality, integrity, and impact of their programs. Qlarant knows what it takes to identify fraudsters and sustain program integrity.
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Transportation Fraud Solutions

In an industry defined by change, Transportation leaders need new solutions to ensure the integrity and success of their initiatives. Discover how Qlarant can improve quality, reduce risk, and get programs on the right track.
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Pandemic Solutions

Qlarant offers proactive and reactive investigations to prevent or stop fraud related to outbreaks, epidemics, and pandemics. Using technology solutions and subject matter experts, we know where to look and what to look for to identify and stop fraud, waste, and abuse quickly.

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Our Fraud, Waste & Abuse Experts

Sandy Love

Sandra Love

As President of Integrity Solutions, Ms. Love is a business leader and innovator with a wide range of progressive executive management experience and consulting expertise spanning more than 30 years in the fields of medical review, risk management, and hospital management.
Aimee Mason

Aimee Mason

Ms. Mason has over 24 years of experience in data mining and statistical analysis to identify and support healthcare fraud, waste, and abuse investigations and audits in the Medicare and Medicaid programs.
Carrie Ward

Carrie Ward

Ms. Ward is an accomplished executive with over 20 years extensive experience in healthcare management, investigative management, and production quality control.
Portrait of Scott Ward

S. Scott Ward

As Program Director, Senior Vice President, Unified Program Integrity Contract (UPIC) Southwest Jurisdiction, Mr. Ward has extensive experience in healthcare fraud, waste, and abuse investigations and audits related to Medicare and Medicaid, working in the field since 1992.
Jonathan Haag

Jonathan Haag

Dr. Haag is a Senior Vice President and Program Director for the Plan Program Integrity MEDIC. He has over 20 years of experience in pharmaceutical and healthcare industries serving in multiple capacities.

Let's Talk Fraud, Waste & Abuse Solutions

How can Qlarant help you combat fraud, waste and abuse?

1-800-999-3362
Qlarant accreditations

Quality Improvement solutions are provided by Qlarant Quality Solutions, Inc., formerly Delmarva Foundation for Medical Care, Inc. Fraud, Waste, & Abuse solutions are provided by Qlarant Integrity Solutions, LLC, formerly Health Integrity, LLC. Data Sciences & Technology solutions may be provided by
Qlarant Quality Solutions, Inc., formerly Delmarva Foundation for Medical Care, Inc.
Qlarant Integrity Solutions, LLC, formerly Health Integrity, LLC, and/or
Qlarant Commercial Solutions, Inc., formerly Health Watch, Inc.

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