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[SHIFT] “An apple a day keeps Fraud, Waste and Abuse away”: How advanced technologies prevent errors, abuse and fraud in health insurance

Shift Technology

48:19

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In the ever-evolving landscape of health insurance, wasteful, abusive, and fraudulent behaviors pose significant challenges, costing insurers millions in lost revenue and inflated claims costs. From falsified documents and fake identities to ghost treatment sessions and upcoding, the spectrum of abuse is vast and continually expanding. While discussions around the potential of AI, Machine Learning and agents are prevalent, many are left wondering: how exactly do these technologies combat waste and abuse?

Join us for an insightful 45-minute webinar where we will share our experiences of most common fraud, waste, abuse and errors, the challenges insurers face detecting and preventing it and how technology can help.

What you will learn:

  • How AI helps uncover FWA by driving higher detection rates
  • How advanced technologies have helped insurers quickly spot FWA in medical documents and invoices to further increase savings
  • Best practices around automating case management and recovery to better support investigation teams
  • Real examples of FWA networks discovered across the globe
  • The wider business benefits of automating FWA detection and prevention

Speakers

Joanne Butler

Joanne Butler

Product Marketing Director, EMEA - Shift Technology

Kelig Aujogue

Kelig Aujogue

Head of Data Science UK - Shift Technology

E

Emma Nunn

Provider Audit & Investigations Manager - AXA Health

Thomas Maggs

Thomas Maggs

Founder and Managing Director - Medical Consulting Group Ltd

[SHIFT] “An apple a day keeps Fraud, Waste and Abuse away”: How advanced technologies prevent errors, abuse and fraud in health insurance

48:19

Watch