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Fraud costs the US health system a lot. As do wasteful spending and abuse of health services. In many organizations the process to detecting these are ad hoc, opportunistic, relying on tip offs, hunches and the curiosity and perseverance of investigators. While these are methods can be effective in isolated cases, they are manual, time consuming, … Continue reading Automating Healthcare Fraud Detection
The US spends nearly $400bn annually on pharmaceutical drugs. Some estimates put the amount of fraud waste and abuse (FWA) above 30% of that.[1] While recent trends point to a slower rate of increase in pharmaceutical spending, there is considerable opportunity to remove wasteful and fraudulent spending on pharmaceuticals. Health analytics provide precise, scalable solutions … Continue reading Pharmacy Fraud Waste Abuse
The Health Analytics Guru 