Healthcare companies face unique challenges in controlling cost and preventing losses proactively. This is especially true with fraud in the healthcare industry, taking the forms of estate planners taking advantage of the terminally ill, nursing home abuse, Medicare fraud and illegal online pharmacies. Fraud is a major contributor to loss in this industry. While many companies rely primarily on the federal government to enforce laws regarding this abuse, more and more healthcare companies are seeking advanced predictive analytics to detect and mitigate fraud before it happens.
StatSoft provides a comprehensive Fraud Detection Solution that uses proven predictive analytics and a robust platform to detect anomalies and characteristics of fraud proactively. Fraud can be detected in any of the problem areas listed above, and more. Potential fraud can be flagged as new data is obtained, enabling real-time fraud detection.
- Leading-Edge Predictive Analytics: Sophisticated algorithms to build models that provide the highest accuracy and best ROI.
- Enhanced Text Analytics: Advanced text miner tool leverages unstructured/textual data such as claim notes within the model building process.
- Enterprise-Wide Solution: A multi-user, role-based, secure STATISTICA Enterprise platform allows for a truly collaborative environment to build, test, and deploy the best possible models for fraud detection.
- Reflexive Models for Real-Time Needs: Live Score® processes new claims as they happen and updates fraud models in rapid turn-around times made possible only by STATISTICA’s integrated solutions.
- Integrated Workflow: STATISTICA Decisioning Platform® provides a streamlined workflow where business rules and industry regulations are used in conjunction with advanced analytics to build powerful predictive models.