Fraud, waste and abuse costs healthcare insurers over $170 billion annually. Mastercard shows Brighterion AI’s capabilities to detect FWA before they pay.
With the growing problem of fraud, waste and abuse (FWA), clearly this complex problem needs a comprehensive solution. Mastercard is excited to present at the National Health Care Anti-Fraud Association conference in Nashville on October 17th to introduce you to Mastercard Healthcare Solutions.
You might not associate Mastercard immediately with healthcare, but the company has been in financial fraud detection for years. To stay ahead of payment fraud, we have invested in the foremost fraud prevention and security platforms. We’ve led the market with superior AI tools for fraud detection within our payment network for the last 15 years.
Watching the FWA claims mount, our team knew it was time to take action on the payer side. “Pay and chase” had sadly become a moniker with Special Investigative Units (SIUs).
Creating Mastercard Healthcare Solutions division
In creating our new division, Mastercard Healthcare Solutions, we recognized the need to hire top healthcare expertise and leverage their knowledge in the complex world of healthcare payments.
We then brought together our award-winning fraud prevention teams with our newly developed Mastercard Healthcare Solutions team. They had one mission: create an end-to-end, real-time AI fraud prevention tool that will predict FWA before it happens.
Mastercard’s suite of FWA solutions
Today, we believe we offer something truly different. The Brighterion AI platform, rated “the most scalable” by Aite Group analysts, is built using distributed architecture. This means unlimited scalability and resilience to disruption as it has no single point of failure. We guarantee 99.9999% uptime.
Distributed architecture allows for lightning speed response times (less than 10 milliseconds) with end-to-end encryption and traceability. This platform can process hundreds of thousands of lines simultaneously and can take data in any format, regardless of source.
Complementing Brighterion AI, is our NuData biometric platform. NuData validates users with passive biometrics that look at users’ unique behaviors. This technology authenticates users, weeding out account takeover and other major threats. Sudden changes in expected behavior like browser type, surfing speed, and time on a page are powerful risk indicators. This layer monitors your traffic changes and flags high-risk deviations.
Our healthcare team at NCHAA
On October 17th, Mastercard Healthcare Solutions will convene a panel discussion, moderated by Jala Attia of Integrity Advantage. Well known in the industry, Jala has run Special Investigation Units and is a veteran in the Payments Integrity market.
From Mastercard Healthcare Solutions, the panelists are Beth Griffin, VP of Healthcare, Cyber & Intelligence, and Tim McBride, Director of Product Development and Innovation. Their topic, “Bringing payment fraud mitigation to healthcare,” will explore the innovation Mastercard offers the healthcare sector. Tim will also share AI FWA detection results and discuss use cases.
Throughout the conference, we’ll be at Booth 102 and welcome all your questions and thoughts. Our team is taking appointments (email: firstname.lastname@example.org) or drop by at any time.