Fraud Detection and Prevention in Healthcare Claims

Fraud and loss affect healthcare payers and providers at a staggering amount each year. This also includes all areas of the business from underwriting to the investigations of claims and payments. In addition, fraud and loss is time consuming to investigate and fraudsters become more sophisticated and utilize more complex methods and technology that make it even harder to detect. The sophistication and pressure from world health events has driven the need for real-time analytics and prevent and intervene strategies.