AI Solutions for Healthcare

Top Fraud, Waste & Abuse
Cases in Healthcare

Payment Integrity Market Trends infographic

It’s become starkly evident: healthcare fraud, waste and abuse is on the rise. Even worse, positive actions taken by government and healthcare organizations to improve patient access to healthcare throughout the COVID-19 pandemic have opened up new opportunities for fraudsters to initiate bigger, bolder and more costly schemes.

See these staggering healthcare fraud trends impacting the industry’s efforts to manage costs and provide quality healthcare.

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.