The Problem: Fraud & Abuse

Every hour this country loses $28.5 million to healthcare FWA - over ten times the amount an average American will earn in their entire lifetime. Totaling as much as $234 billion annually, medical FWA is a problem that is simply too large to ignore. Effectively combating a problem of this magnitude requires an innovative, multi-disciplinary approach to FWA detection. 

The Solution: Fraud Finder Pro

 

Features

  • Highly customizable rules, data feeds and user experience
  • Predictive analytics, link-analysis and multi-variant models
  • Profile and score high-risk providers and fraud schemes
  • Advanced case-tracking, data-visualizations and SIU services
  • Clinical review and validation of all suspect billing activity

Benefits

  • Achieve referred case-open rates up to 80%
  • Increase FWA program savings and detection rates
  • Minimize false positives and boost SIU efficiency
  • Stop fraud and abuse before claims are paid
  • Meet all FWA program needs with a single solution 

Next Steps

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