From Pay and Chase to Prevent and Save: Mitigating FWA with Innovative AI
March 31, 2020
Sponsored by: Mastercard
2:00 pm ET
Mastercard Healthcare Solutions provides a proven AI solution that differentiates by leveraging its experience in payment fraud to complement claim fraud mitigation. Mastercard Healthcare Solutions’ unique competency supports post-pay detection, while also creating prospective (pre-pay) models built by identifying anomalies found in historical claims data (post-pay). In this webinar, you will learn how you can increase detection of fraud, waste and abuse (FWA) before sending good money for bad claims, significantly reducing inefficient pay-and-chase activities while moving toward a prevent and save business model. With increased detection of true FWA, false positives are greatly reduced, anomaly detection is significantly increased, and payers can focus their investigators’ time on highly-likely FWA.
All registered webinar attendees will receive a complimentary Aite Group research paper “Putting AI to Use in Fraud, Waste, and Abuse”
President, Integrity Advantage
Vice President of Healthcare Product Development and Innovation, Mastercard
Director of Healthcare Product Development and Innovation, Mastercard
Provider fraud hits the bottom line directly, adversely affecting quality of care and health outcomes. Fraud, waste and abuse (FWA) takes on added meaning in our newly emerging world of performance/value models.
The growing complexity of risk-based payments is expanding the focus of PI/SIU/SUR departments. We need new analytics strategies to identify FWA in this new paradigm.
In this webinar, we will discuss techniques, algorithms and data investigations as the cutting-edge tools needed for today's fraud investigator.
Principal Solutions Architect Global Fraud, Risk and Security Intelligence Practice, SAS
With more than 30 years of health care experience, Tom Wriggins is a respected thought leader within government health care and data analytics. He is responsible for business analysis and analytics design, data management consultation, application and interpretation of comprehensive program/payment integrity, and data analysis solutions.