Fraud, waste, and abuse is a dynamic and multi-variable challenge for insurers, governments, and healthcare and financial organizations. It's a claims problem, a behavioral problem, a relationship problem, a technology problem, and most of all, it’s a timing problem. Too much of the FWA focus is on pay-and-chase models or limited to a linear, rules-based claims review.
Our FWA Prevention & Recovery solution addresses FWA from an integrated claims, provider, customer, and intermediary level. By analyzing data such as decisions, relationships, content, transactions, and procedures, you get intelligence that helps you prevent FWA payments before they happen. And the same technology can be applied to retrospective analysis for improved recovery.
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