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Health Insurance Fraud Detection Solutions

Fraudulent health insurance claims are an increasing burden on the healthcare system, and perpetrators use a wide array of fraud strategies. For example:

  • Providers may bill for services not actually provided, or deliver treatments, or purchase equipment that are not medically necessary
  • Policy holders allow others to use their insurance, or conspire with providers to inflate the cost of treatment, or claim for fictitious treatments

In today's world of paperwork and transaction recording, the evidence your need to pinpoint fraudulent activity already exists. However, most health insurance providers do not have the systems available to interrogate and cross-reference all of the available data, mine it, and monitor for the signatures of fraud.

A key issues is being able to cross-reference both structured and unstructured content, some of which may still be paper-based.

Getting started, and putting fraud detection systems into place can seem daunting, and simply beyond available budgets.

At Search Technologies, we help insurance providers to make a start, and build pragmatic, cost-effective systems, often using proven open source software. Once a start has been made, and the return on investment can be clearly seen, this can lead to further, more substantial funding, and the ability to contemplate a comprehensive suite of health insurance fraud detection capabilities.

Search Technologies is an independent consulting and implementation services company, focused on search and big data solutions. We know how to capture, organize and index data from all sources, and use it to create easy-to-use solutions for fraud investigators.

Through our application assessment service, it's easy, low cost and low risk to get started. Contact us today for an informal discussion of your ideas for combatting health insurance fraud. We will help you to make them a reality.

With more than 500 customers, we have the expertise and experience to help you to cut fraud.