1. / PayAssure – Fraud Propensity Scoring for Payers

PayAssure – Fraud Propensity Scoring for Payers

Payment integrity controls are utilized in some form or another by all payers to save money. Their efforts, however, are primarily focused on pre-payment and post-payment identification and are scattered across multiple departments. In many circumstances, the savings realized may only be a fraction of the total possible. Predicting fraud and identifying loss to enhance the medical loss ratio can help organizations recuperate hundreds of millions of dollars each year in today’s environment. PayAssure addresses payers’ increased fraud surveillance and detection demands with a holistic analyst-centric strategy. It aids with verification and enrolment, as well as investigative support, pre and post-pay analytics, auditing, and recovery. When determining a claim outlier, we use the power of various entity risks and powerful AI/ML algorithms, limiting false positives and prioritizing the highest risk claims.

You are just a step away to downloading brochure

    © 2022 Apexon. All Rights Reserved.