Projects and references
FRAUD DETECTION in health insurance
Helps health insurers to identify non-standard procedures and deviations in health care providers’ reported care that do not reveal the standard control systems used.
Purpose
Helps health insurers to identify non-standard procedures and deviations in health care providers‘ reported care that do not reveal the standard control systems used.
Solution
Using Business Intelligence and Artificial Intelligence can identify potential fraud cases.
Key features and benefits
Savings
Provable savings due to a higher efficiency of the money spent on health care
Communication
Possibility to communicate with health service providers in terms of prevention and methodology in the reporting of healthcare
Cost reduction
Cost reduction of the process itself for finding deviations and nonstandard procedures
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