Medical Seeding

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Medical Seeding Verification

Medical Seeding & Provider Verification

Medical Seeding is the process of validating the existence and credentials of healthcare providers, including doctors, pharmacies, and diagnostic centers. In the insurance industry, "paper clinics" or "ghost pharmacies" are often created solely for the purpose of generating fake bills. Medical Seeding ensures that the provider listed on a claim is a legitimate, practicing entity with valid licenses.

Aziza helps insurers build a "Whitelisted" database of verified providers while flagging suspicious entities that show patterns of fraudulent billing or lack proper medical infrastructure.

Our Seeding Parameters:

  • Doctor Credentialing: Verifying registration numbers with Medical Councils and confirming the doctor's physical presence at the stated clinic.
  • Facility Infrastructure Audit: Checking if a hospital or diagnostic center actually possesses the equipment (like MRI or OT) they are billing for.
  • Pharmacy Legitimacy: Confirming valid drug licenses and verifying if the pharmacy maintains a real inventory of the medicines mentioned in claims.
  • Geographical Tagging: Using GPS and photographic evidence to confirm the physical location of the medical entity.

Why it is Crucial for Insurers:

Effective medical seeding acts as a first line of defense against organized insurance rackets:

  • Eliminating Fake Providers: Identifies clinics that exist only on paper.
  • Preventing Referral Scams: Detects suspicious patterns where a specific doctor consistently refers patients to a specific "high-cost" pharmacy or lab.
  • Network Management: Helps insurance companies decide which hospitals to include or exclude from their "Cashless Network."

The Aziza Methodology

We don't just rely on online directories. Our team performs physical mystery shopping and on-site visits to verify that medical providers are operating ethically and legally. This deep-level seeding provides an extra layer of security for your claims department.

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