The advent of Telehealth and Telemedicine have resulted in a proliferation of these instances. How do we deal with this altered environment? How do we stay ahead of the curve of emerging new fraud strategies?
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Fraud has been causing rising challenges for businesses. Over 72% of businesses cite fraud as a growing concern, and about 63% of businesses report the same or higher levels of fraudulent losses over the past 12 months according to a report by Experian Global. The…
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Healthcare claims are an inviting and alluring target for fraudsters due to their huge monetary value. In 2017 alone, HHS and DoJ recovered around 2.5 Billion Dollars in claims fraud. And that is just one year. The challenges facing healthcare payers are manifold as they…
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With data driving most business transactions, it is essential to analyze and interpret patterns in behavior correctly. NEMESIS, an anomaly detection tool powered by machine learning, can detect and predict against abnormal behaviors in data that signal threats of risk and fraud.
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“COVID-19!” the mere mention of the word sends an ominous shiver down our spines! Such has been the phenomenal negative buzz associated with the rise and spread of the Novel Coronavirus, from Wuhan China to what appears to be every nook and corner of the…
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Mobile phones, smart watches, wearable health gears… there is avalanche of information and data about people’s health and activities today that can be leveraged. The data can be used to have more a clear idea of a person’s health and fitness needs. Hospitals and healthcare…
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Healthcare claims are inviting and alluring target for fraudsters due to their huge monetary value. In 2017 alone, HHS and DoJ recovered around 2.5 Billion Dollars in claims fraud. And that is just one year. The challenges facing health care payers are manifold as they…
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