Description
Early detection of improper payments. Predictive, accurate claims decisions. And hundreds of millions in savings. We can help you get ROI from your payment integrity efforts with solutions that address:
Fraud and improper payments waste and abuse. Detect improper payments before the money goes out the door, and get potential savings of hundreds of millions of dollars. Take an enterprise approach to detecting and preventing fraud, waste and abuse with a hybrid analytics solution.
Eligibility fraud. Determine eligibility in Medicaid, MCOs and state employee and traditional health plans to avoid unwarranted costs – using sophisticated analytical tools and a variety of data sources.
Enterprise case management. Manage investigation workflows, attach commentary and record financial information, such as exposures and losses using a holistic, structured case management environment.