Why Excel Isn't the Solution for Payment Integrity
(Room Balboa ABC)
19 Nov 15
10:15 AM
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11:15 AM
Tracks:
Anti-Fraud Technology Solution
To prepare for today's data challenges and beyond, government-funded and commercial insurance plans need a data management infrastructure that provides access to data across various channels. Because unscrupulous providers and suppliers often intentionally give inaccurate, incomplete or inconsistent information to prevent records matching across disparate systems, insurance plans need data quality capabilities that support entity resolution. To make use of all data sources, insurers need a robust business analytics foundation to identify suspicious patterns pointing to programmatic fraud, waste or abuse. And they need an infrastructure designed to stop improper payments, instead of chasing the money after it's long gone.