Build a FWA AI solution
Budget: $250 – $750 USD
I'm a Consultant seeking develop an IT solution that is
AI-powered platform that enables insurers to automate claims seamlessly and also track fraud, waste and abuse (FWA) by leveraging on information such as patients records to physicians certifications, insurers can automate fraud detection using modern data analysis programs which can often detect fraud automatically. It's will be a single advanced AI model that provides its own updates through real-time, continuous self-learning, adapting to the changing behavior it observes. It also learns through the final disposition of cases and claims, so can identify valid claims and flag new behavior patterns that may indicate fraud. The end result is a reduction of 20x in false positives, providing likely-fraud alerts to investigators for follow up
The solution will have the ability to detect potential fraud before policy issuance,
prevent payment errors, detect fraudulent claims, improve cash flow, achieve cost-saving related to time and human resources spent on claims processing improve claims processing turnaround time and reduce unintentional waste and overcharging
AI-powered platform that enables insurers to automate claims seamlessly and also track fraud, waste and abuse (FWA) by leveraging on information such as patients records to physicians certifications, insurers can automate fraud detection using modern data analysis programs which can often detect fraud automatically. It's will be a single advanced AI model that provides its own updates through real-time, continuous self-learning, adapting to the changing behavior it observes. It also learns through the final disposition of cases and claims, so can identify valid claims and flag new behavior patterns that may indicate fraud. The end result is a reduction of 20x in false positives, providing likely-fraud alerts to investigators for follow up
The solution will have the ability to detect potential fraud before policy issuance,
prevent payment errors, detect fraudulent claims, improve cash flow, achieve cost-saving related to time and human resources spent on claims processing improve claims processing turnaround time and reduce unintentional waste and overcharging