Fraud: Integrating Predictive & Social Networking Analytics

Venue: Internet

Location: -

Event Date/Time: Apr 28, 2011 End Date/Time: Apr 28, 2011
Report as Spam


In the last decade, predictive analytics has become an important part of the health care delivery workflow. The ability of this technology to analyze vast amounts of claims data and provide actionable insight leading to improved health care delivery and operational efficiency is proven.

To date however, the promise of predictive analytics to detect fraud in health care has been for the most part unfulfilled. The predictive analytics utilized so successfully in the credit card industry were initially touted as a quick fix that would simply shift directly over and start doing the same thing for health care. The complexity, variability, and "dirty data" involved in health care have prevented that from happening in the way that was hoped for.

The key problem in fraud detection has been far too many false positives. Pulling claims out of the payment work flow, only to find out after manual review that they are payable, causes significant business and compliance problems for both payors and providers.

During this complimentary webinar LexisNexis® Risk Solutions and ViPS, a General Dynamics Information Technology company, will explore a fundamentally new and unique model for incorporating fraud risk control by implementing predictive analytics and social networking analytics at the front end of the business workflow.