AI Solutions for Healthcare

FraudScope Announces Upgrades to its Proprietary Case Management and Reporting Technology

FOR IMMEDIATE RELEASE

FraudScope Announces Upgrades to its Proprietary Case Management and Reporting Technology

FraudScope Adds New Capabilities to Case Management Offering to Address Expanding Customer Needs 

ATLANTA (April 7, 2020) – FraudScope, an AI-based platform that helps health plan special investigations units, payment integrity, and medical review teams investigate fraud, waste, and abuse (FWA), today announced it has made significant upgrades to its case management and reporting capabilities. The upgrades, which were driven by FraudScope health plan SIU customer needs, better enable teams to more efficiently and effectively collaborate across the organization and to open, investigate and resolve fraud cases.

“The fraud industry is constantly changing, and FraudScope is committed to evolving our offerings to provide our customers with unparalleled industry tools for identifying suspicious claims, gathering actionable data, and resolving cases quickly,” stated Musheer Ahmed, CEO of FraudScope. “Our customers have seen dramatic results with the FraudScope AI platform and we are determined to keep improving and expanding our capabilities to drive even better outcomes and enhance their experience.”

FraudScope’s upgraded case management features include:

  • New case dashboard: Provides several visual highlights for cases within the platform along with the ability to make quick updates to any case
  • Enhanced team coordination: Allows users to create and assign cases to individuals or teams throughout the organization
  • Detailed case notes: Allows users to capture formatted notes within tracked events along with the ability to search and sort them by various options
  • Easy event scheduling: Allows users to schedule events and assign them to team members in the case calendar and export them into a calendar application such as Outlook or Google
  • Improved configuration of case fields and options: Enables users to customize case fields and dropdown options easily with customer specific preferences
  • Flexible and customized report creation: Gives users the ability to create flexible reports based on custom report templates defined by them. This helps meet any reporting requirements or regulations with ease

FraudScope recently announced that it added more than 75 customer-driven enhancements to its platform in 2019, including new capabilities for facility and pharmacy FWA detection and investigation and a ‘collusion’ capability that helps plans identify cases where patients, providers, facilities and/or pharmacies are colluding to commit FWA.

FraudScope’s AI platform with the case management enhancements and upgrades is available now.  More information about FraudScope and its solutions can be found at https://www.fraudscope.com/solutions/.

About FraudScope
FraudScope is an AI-based platform that accelerates the identification of fraud, waste, and abuse. Our comprehensive claims investigation platform utilizes proven and patented AI-based technology to empower investigators and analysts to derive insights and conduct full investigations of suspect claims.  For additional information about FraudScope and our solutions, visit https://www.fraudscope.com.

For More Information Contact:
David Grice
(678) 296-8918
david.grice@fraud-scope.com

FORENSIC AI PLATFORM

Our Forensic AI Engine analyzes your data, detects problems, and builds connections across your data to provide actionable insights

Insight Scope

For everyone across the health plan

Clinical Scope

For clinical teams

Audit Scope

For everyone across the health plan and PBM

Network Scope

For network teams

Payment Scope

For payment integrity teams

Provider Scope

For network and payment teams

Fraud Scope

For SIU teams

SERVICES

We provide a full range of professional services, from data migration and ongoing customer success through flexible virtual SIU options.