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A robust database, predictive analytics and clinical validation
combined to identify emerging schemes and pinpoint fraud losses.
To learn more about this need, view white papers, case studies, webinars and more.
We effectively attack the entire continuum of fraud, waste and abuse (FWA) by providing a complete solution that leverages the most advanced payment accuracy platform, a real-time processing engine and our unique power of clinical validation. Our fully-integrated solutions are the most effective measure to detecting and preventing the entire FWA continuum.
The United States healthcare system loses up to $234 Billion in annual fraud, waste and abuse. Broken down that can equal as much as $63 Billion in physician and clinical spending, $12 Billion in dental, $100 Billion in facility and $30 Billion in pharmacy claims.
Annual losses to physician and clinical billing waste.
Annual loses from facility bill waste and abuse.
Improve dental claim payment accuracy by leveraging our real-time editing solutions and dental experience.
Reduce your facility claims with our expertise in editing and negotiation.
Prospectively identify new and emerging fraud schemes with next generation technology and clinical review.
Apply clinical and predictive modeling with clinical validation to increase accuracy and minimize false positives.
View and pay claims on the most user-friendly payment accuracy software ever built.
Deliver superior payment recommendations by combining sub-second processing with transparent, open-source edits.
