Healthcare fraud affects more than just the medical community. It affects everyone. If healthcare were an economy, it’d be the 19th largest in the world. Healthcare is growing at a rate of 5.5% per year, but fraud is growing at a rate of 6.5%. Yes, fraud’s growth is outpacing healthcare, meaning it’s reaching more and more people at a faster rate.
Fraudulent claims carry a high risk and high price tag financially. These fraudulent claims can also influence the perception of value and integrity in the health care system.
Healthcare Fraud Is a Crisis
Per the National Health Care Anti-Fraud Association, tens of billions of dollars are lost every year due to health care fraud. What does this mean for your organization? You need to do everything you can to crack down on healthcare fraud using healthcare fraud software. This type of fraud is not a victimless crime, and there are devastating effects. Does your organization have tools in place to prevent this type of fraud? Do you have enough trained staff to even review claims? The right software can help you meet this crisis head-on.
Does Your Organization Have Time to Review Claims?
Often times, prompt payment regulations keep payers from being able to fully review claims for abuse, fraud, and waste. This is especially true in the face of a shortage of trained medical professionals expected to handle millions of claims that are submitted daily. It is impossible to review more than just a small percentage of claims before they are to be paid. This leaves organizations open to post-payment collection situations that force payers to try to recover payments that are incorrect after being paid. It’s time to stop this negative cycle.
Detect Fraud Easily with Healthcare Fraud Software
Your organization needs a forensic tool like healthcare fraud software that utilizes advanced artificial intelligence. Consider this type of software to be a fraud and abuse management system that can identify and analyze different fraud scenarios, misuse, and excess within healthcare transactions and claims. Healthcare fraud software can be implemented as a stand-alone product or it can easily be used cohesively with an existing data infrastructure.
Medical Fraud Detection Just Became Easier
Healthcare fraud software ensures that organizations and trained healthcare professionals can easily analyze massive volumes of information in regards to claim payments. A top hybrid software system learns from interactions with verified claims data and trained professionals which gives it the ability to pinpoint issues accurately and form conclusions. A review process is augmented by the system while being able to uncover patterns of abuse and fraud that were once previously unknown.
Your organization needs a flexible anti-healthcare fraud system working from a platform that can consume millions of electronic healthcare claims. The system helps to identify fraudulent healthcare errors and charges as well as medical abuse no matter how complex they may be. When the system suspects any issues, it presents clear and concise information via data and visual formats so charges for payments can be appropriately addressed.
Use Healthcare Fraud Software That Learns from Human Interactions
By using fraud software that learns continuously from human interactions you are giving your operation the ability to better detect fraud, manipulation, and waste in regards to medical billing abuse. You are guaranteed round-the-clock, seamless audits of millions of claims while top ai fraud systems also adjust to fresh data to continue to prevent potential fraud. This could save up to millions of dollars and significantly helps cut losses for a growing epidemic.
Clean Up Your Revenue Cycle
With the correct fraud detection software, you will have a powerhouse in place that targets abuse using profound subject matter proficiency to assist with claims reimbursement, Medicare fraud detection, and the prevention of millions of dollars of misuse. Detection software can help to uncover probable criminal activity and put a stop to it. Clean up your revenue cycle the easy way by removing waste, fraud, and abuse with an ai healthcare fraud system.