We are changing that!
Learn More30 page special report on emerging COVID-19 related FWA schemes
Our comprehensive platform uses patented AI technology to detect problematic claims and empower your analysts and investigators to control costs. Our behavioral analysis and detection engine shows you recent provider behavior and claims patterns, and can detect new and emerging fraud schemes before they add up to a bit hit on your bottom line.
Learn MoreInsight Scope – Gives everyone across the health plan an easy way to research issues with self-service reporting and querying of claim, provider, facility and member behavior.
Provider Scope – Compares each provider’s claims and coding practices to their peers, identifies outlier behavior, and proactively engages providers to improve claim integrity and bring down pre-claim costs with a provider self-monitoring and communication portal.
Fraud Scope – AI automatically identifies new and emerging fraud schemes, streamlines collection of evidence chains, and gives SIU teams integrated case workflow for the investigations you choose to purse.