Ferrand will lead the company’s enhanced LTC fraud program
June 30, 2020 – LTCG, the leading insurance administration and claims solution provider for long term care (LTC) insurance, has just announced that respected industry thought leader Jeff Ferrand has joined the company as its Vice President of Fraud Services. In this capacity, Ferrand will head up the company’s enhanced fraud service offering that will add proactive fraud data analytics and experienced fraud investigation capabilities to LTCG’s existing red flag detection services. LTCG’s approach is the first of its kind in the LTC insurance industry, which has experienced dramatic increases in claims over the past five years and an associated rise in fraud, waste and abuse.
LTCG is partnering with outside data analytics experts to develop suspected fraud detection criteria based on the company’s vast amount of industry and claims data. Through proprietary algorithms and machine learning, these dynamic criteria will be used to automatically identify suspicious claims for additional review. Ferrand’s team of fraud investigators will then review the cases and will be able to manage the entire process for LTCG’s clients from start to finish. This group will be dedicated to addressing all of the unique challenges that come with fraud detection in the LTC insurance space.
Ferrand is an insurance attorney and fraud expert well-regarded by all of the leading LTC insurers. He joins LTCG after serving as the chief fraud officer at Fuzion, where he oversaw claims fraud, waste and abuse mitigation efforts and all claims special investigations. Over the past several years, Ferrand led the development of programs that have significantly decreased financial losses for his clients and has lent his expertise as a speaker, author and contributor on numerous LTC insurance fraud-related topics. He is also actively involved in the industry’s LTCi Anti-Fraud Forum, serving as its chair since 2017.
In this new role, Ferrand will lead the development of LTCG’s end-to-end fraud detection, investigation and mitigation solution, overseeing an experienced staff of fraud professionals. He will also design LTCG’s data mining approach, which will leverage volumes of data the company has gained over 25 years in business as the largest third-party claims payer serving leading LTC insurers.
“Joining LTCG gives me an incredible opportunity to apply the knowledge I’ve gained in insurance fraud over the past two decades,” said Ferrand. “Because the company serves all of the top insurers and has such a significant amount of data, I’m equipped to immediately start working with my new team to build out this cutting-edge solution.”
A recent survey of LTC insurers by the Society of Actuaries showed that the majority of respondents believe that fraud, waste and abuse are not being effectively addressed within their industry today. The same survey showed 40 percent of these insurers believe that “a lack of knowledge, training and technology” presents the biggest challenge in effectively addressing these issues, demonstrating the need for LTCG’s fraud program.
“We are making a substantial investment to enhance our fraud detection and mitigation capabilities, which fits within our strategy to offer value-added claims management services to our growing list of clients,” said LTCG’s CEO Peter Goldstein. “Given his wealth of experience and exceptional reputation as a leader in the fraud space, we’re very excited to have Jeff join our management team.”
This new addition to LTCG is just one of the ways that the company is developing a world-class claims management solution to address this trend. LTCG has also recently built out its CareExchange EVV platform, along with wellness and electronic claims solutions that will help its customers better manage these costs.
LTCG is the leading provider of administrative solutions and clinical services to the long term care and life insurance industry, with over two decades of experience in this space. LTCG currently manages over one million policies and serves more than 100 carriers nationwide. The company addresses all types of customer needs and policy requirements—from application processing and underwriting of new business to claims and administration of open and closed blocks. LTCG’s advanced data analytics, actuarial and risk management capabilities and unmatched industry expertise can help organizations manage their business and develop emerging products such as hybrid life/long term care policies. LTCG also helps carriers bend the cost curve through innovative provider solutions and wellness programs. For more information, visit www.LTCG.com.