Mastercard® Healthcare Solutions
EBOOK

Proven AI technology increases accuracy in healthcare fraud detection while minimizing false positives

The healthcare industry loses hundreds of billions of dollars each year to fraud, waste and abuse alone.

Healthcare insurers detect only a small fraction of suspicious claims, resulting in rising healthcare costs and higher premiums for patients. The industry faces increasingly more complex schemes such as provider fraud (e.g. phantom billing, upcoding, excessive billing), member fraud (e.g. borrowed or stolen ID) and pharmacy fraud (e.g. non-existent patients, “doctor shoppers”).

Read this Ebook to learn how:

  • Proven AI fraud prevention technology is being applied to healthcare fraud, waste and abuse
  • Advanced AI detects and prevents fraud before the claim is paid
  • Higher detection rates and fewer false positives allow you to focus on more complex FWA schemes

Please contact sales@Brighterion.com should you wish to speak to an AI expert or request a copy of any of our eBooks, white papers or to view one of our pre-recorded webinars.

Proven AI technology increases accuracy in healthcare fraud detection while minimizing false positives

The healthcare industry loses hundreds of billions of dollars each year to fraud, waste and abuse alone.

Healthcare insurers detect only a small fraction of suspicious claims, resulting in rising healthcare costs and higher premiums for patients. The industry faces increasingly more complex schemes such as provider fraud (e.g. phantom billing, upcoding, excessive billing), member fraud (e.g. borrowed or stolen ID) and pharmacy fraud (e.g. non-existent patients, “doctor shoppers”).

Read this Ebook to learn how:

  • Proven AI fraud prevention technology is being applied to healthcare fraud, waste and abuse
  • Advanced AI detects and prevents fraud before the claim is paid
  • Higher detection rates and fewer false positives allow you to focus on more complex FWA schemes