Health Insurance Fraud Detection Solutions

Listing Websites about Health Insurance Fraud Detection Solutions

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Insurance Fraud Detection Solutions: Health Insurance, …

(4 days ago) WEBCustomer Story Turkish insurer achieves real-time fraud detection Aksigorta uses advanced analytics to increase fraud detection rate by 66 percent. SAS was named a Luminary in Celent's Insurance Fraud Detection Solutions: Health Insurance, 2022 …

https://www.sas.com/en_us/news/analyst-viewpoints/celent-insurance-fraud-detection-solutions-health-insurance.html

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Insurance Fraud Detection Solutions: 2022 Health Insurance …

(1 days ago) WEBThis report provides an overview of fraud-detection solutions for health insurance providers. The report profiles 5 claims fraud-detection solutions providing …

https://www.celent.com/insights/141618443

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Insurance Fraud Detection & Prevention Solutions

(3 days ago) WEBInstantID® for Insurance combines verification, validation and risk detection processes in near-real-time to help you better understand your customers and reduce risk. InstantID …

https://risk.lexisnexis.com/insurance/fraud-detection

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SAS Payment Integrity for Health Care SAS

(3 days ago) WEBKey Features. A single, fully integrated solution for ensuring payment integrity in health care, with components for fraud detection, alert management and case handling. Plus enhanced AI capabilities, such as …

https://www.sas.com/en_us/software/payment-integrity-for-health-care.html

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Shift Technology AI for Insurance Decisions

(3 days ago) WEBGo beyond fraud, waste, and abuse detection to identify issues at the patient, provider, and network levels. Claims. Shift’s AI-driven insurance decision solutions deliver greater-than-human accuracy. Extreme …

https://www.shift-technology.com/

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Health Insurance Fraud Detection: Explainable AI …

(1 days ago) WEBBy deploying this solution, Health Plans can realize more efficient investigations and fight health insurance fraud without restructuring the way they operate. For more insights, watch or listen to …

https://www.shift-technology.com/resources/perspectives/health-insurance-fraud-detection-explainable-ai-matters

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AI for Health Insurance Fraud Detection – Current …

(9 days ago) WEBThe company lists health insurance fraud detection is one of the solutions their platform can provide with some development. H2O.ai also claims there …

https://emerj.com/ai-sector-overviews/ai-for-health-insurance-fraud-detection-current-applications/

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SHIELD MR HealthTech - Munich Re

(2 days ago) WEBUnlike other fraud analytics solutions, SHIELD not only detects potential fraud but can also approve or reject a claim, based on medical rules and machine learning models.

https://www.munichre.com/mrhealthtech/en/solutions/shield.html

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Healthcare Solutions LexisNexis Risk Solutions

(8 days ago) WEBPlease fill out the form below and we'll be in touch shortly, or call us for immediate assistance at 1-866-396-7703. For more information about how we may use your …

https://risk.lexisnexis.com/healthcare

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Top 5 Technologies Improving Insurance Fraud Detection in 2024

(8 days ago) WEBAccording to the FBI, insurance fraud (excluding health insurance) costs more than $40 billion annually in the U.S. alone.When we add health insurance costs, …

https://research.aimultiple.com/insurance-fraud-detection/

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Health Insurance Fraud Detection Solutions - Megaputer Intelligence

(9 days ago) WEBDetect anomalies. Our health insurance fraud detection solution analyzes claims to determine normal behavior patterns and detect possible fraud and abuse. The system …

https://www.megaputer.com/solutions/health-insurance-fraud-detection/

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Daisy Intelligence AI Solutions for Insurance

(3 days ago) WEBFor health insurance, Daisy’s system identifies Halo Effects to: Daisy’s integrated suite of solutions detects fraud, automates claims processing, and underwrites risk - …

https://www.daisyintelligence.com/insurance-solutions

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FRISS Claims Analytics

(6 days ago) WEBRevolutionize your claims verification process. Elevate claims management by providing claims adjusters with advanced analytics and real-time insights to swiftly identify and …

https://www.friss.com/products/fraud-detection-at-claims

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Fraud Detection with AI H2O.ai

(7 days ago) WEBAI is ideally suited to fraud detection for medical claims. Machine learning models can be used to automate claims assessment and routing based on existing fraud patterns. This …

https://h2o.ai/solutions/use-case/claims-fraud-detection/

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Advancing Health Insurance with AI: Omdena's Impactful Solutions

(Just Now) WEBOmdena Case Study 1: Fraud Detection in Insurance Claims. Fraud detection is a critical aspect of insurance operations. This operation oftentimes …

https://www.omdena.com/blog/advancing-health-insurance-with-ai-omdenas-impactful-solutions

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Data science for health insurance fraud detection - REACH

(9 days ago) WEBSummary of the challenge: The objective of the challenge is to develop solutions that allow anti-fraud agencies and insurance companies to detect fraud in …

https://www.reach-incubator.eu/project/data-science-for-health-insurance-fraud-detection/

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Health insurance fraud detection based on multi-channel …

(2 days ago) WEBHealth insurance fraud is becoming more common and impacting the fairness and sustainability of the health insurance system. Traditional health insurance fraud …

https://ui.adsabs.harvard.edu/abs/2024Heliy..1030045H/abstract

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Health Care Data Analytics SAS

(1 days ago) WEBHealth care data analytics solutions from SAS provide insights that drive better population health, health care operations, prevention of fraud, waste & abuse. SAS is a …

https://www.sas.com/en_us/industry/health-care.html

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Fraud, Waste and Abuse (FWA) - HCP

(8 days ago) WEBFalse Claims Act. The False Claims Act (FCA) is a federal statute that is intended to prevent healthcare fraud and recover losses involving any federally funded contract or program, …

https://www.healthcarepartnersny.com/wp-content/uploads/2020/08/FWA-Provider-Training_Aug-2020.pdf

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District of New Jersey Announces Charges in Health Care Fraud …

(4 days ago) WEBAndrew McCubbins, 39, of Draper, Utah, the owner of a telemedicine company, pleaded guilty by videoconference on Sept. 24, 2020, before U.S. District …

https://www.justice.gov/usao-nj/pr/district-new-jersey-announces-charges-health-care-fraud-cases-part-nationwide-federal-law

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No easy fixes to Obamacare enrollment fraud : Shots - Health …

(3 days ago) WEBThe agency is also working closely, he wrote, with insurance companies, state insurance departments, and law enforcement "so that agents violating CMS rules …

https://www.npr.org/sections/health-shots/2024/05/07/1249417648/aca-health-insurance-brokers-obamacare-stop-fraud

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Medicare and Medicaid fraudsters continue to steal taxpayer money

(1 days ago) WEBHealthcare fraud was the leading source of False Claims Act settlements and judgments in fiscal year 2023. In addition to recovering taxpayer funds and deterring …

https://www.thomsonreuters.com/en-us/posts/investigation-fraud-and-risk/medicare-medicaid-fraud-2024/

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The Benefits of AI in Healthcare IBM

(7 days ago) WEBFraud prevention: Fraud in the healthcare industry is enormous, at $380 billion/year, and raises the cost of consumers’ medical premiums and out-of-pocket …

https://www.ibm.com/think/insights/ai-healthcare-benefits

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Payment Integrity Solutions - Conduent

(2 days ago) WEBexperience, and extensive knowledge of health care systems makes Conduent an ideal partner to assist in the proactive search for fraud, waste and abuse and mis-paid claims …

https://downloads.conduent.com/content/usa/en/brochure/pharmacy-audit-ancillary-services.pdf

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Julio Pernía Aznar: Revolutionising Car Insurance Cash Settlements …

(9 days ago) WEBThe implementation of AI in fraud detection has led to impressive results. For example, the insurance industry has seen a significant reduction in fraudulent activities, …

https://insurtechdigital.com/articles/insurance-cash-settlements-ready-for-an-ai-overhaul

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