The use of a claims analytics platform helped Medicare to identify and prevent millions of dollars in provider fraud.
“Close to a quarter of new Medicare fraud investigations started with the use of a claims analytics platform that has helped to save approximately $6.7 million in incorrect billings, a new GAO report found. After reviewing fraud prevention procedures and technologies within Medicare in 2016, GAO determined that the Fraud Prevention System (FPS) helped Medicare take corrective actions against 90 providers by suspending improper payments. The review also suggested that the FPS is helping CMS programs curb their historical fraud vulnerabilities.” Read the full article.
The data from an all-payer claims database can reduce wasteful healthcare spending by supporting population health and analytics-driven healthcare decision making.
HxLogic is a powerful pre-built data warehouse and analytics solution that provides healthcare organizations with near real-time information to fundamental subjects like
