What is FraudLens?

FraudLens is the First Near Real-Time healthcare fraud, waste and abuse automated detection and prevention software solution that is specifically designed to reduce the financial burden caused by pre-payment of high volume, low dollar FWA (constituting more than 90% of all FWA) in addition to low volume, high dollar FWA.

Why FraudLens?

FraudLens is an intelligent software solution that enables healthcare payers to increase savings significantly from fraud, waste and abuse (FWA) by moving from a decades-old “pay and chase” and “manual review” model to a smart, automated "detect and prevent” model. These new savings can be used to fund new initiatives.

How FraudLens Works

FraudLens applies its Multi-Vectored technology combining multiple smart and connected algorithms on all claims data every day. FraudLens reports within 24 hours (pre-payment & pre-adjudication) exactly who has committed FWA, what was fraudulent, when it happened, where it happened, and how it happened.

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Automated Detect & Prevent instead of Pay & Chase Approach

Solutions We Provide

FraudLens is a one-of-a-kind medical and dental healthcare Fraud, Waste and Abuse detection and prevention solution that combines informatics, clinical expertise, forensics, information technology and advanced data visualization to reduce your FWA.

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Multi-Vectored FWA Analysis

Despite years of effort and a plethora of variations of the “pay and chase” model, the percentage recovery as reported in 2013 by the Office of the Inspector General (OIG) of Health and Human Services was less than 6% of the total estimated healthcare FWA.

FraudLens uses a Multi-Vectored technology with multiple smart and connected algorithms to automatically detect and prevent most of the Fraud, Waste, and Abuse with precision within 24 hours.

Significant Increase of ROI

FraudLens believes that the best way to stop these losses is through
early detection (pre-payment) and prevention (better provider management).

678-644-0752 beth.runfola@fraudlens.com
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