Tag: fraud detection

Analytics | Fraud & Security Intelligence
Tom Wriggins 0
COVID opens door to pervasive healthcare fraud

It's easy to get distracted by new developments in the fight against healthcare fraud. New services. New providers. Relaxation of rules. The COVID-19 pandemic has quickly revolutionized the healthcare landscape. For instance, the government made sweeping regulatory changes to accommodate a surge in patients. Healthcare delivery and payment organizations, commercial

Analytics | Fraud & Security Intelligence | Risk Management
Francois Jaussaud 0
Risques de contrepartie : ne confondons pas les risques financiers et les risques criminels

Le point de vue et l’approche développée par SAS Toute entreprise ou organisation est confrontée au risque de contrepartie, dès lors qu’elle est en relation avec un tiers. Ce risque est inhérent à toute relation commerciale entre deux entités (personnes morales et/ou physiques), mais également aux dispositifs financiers tels que

Advanced Analytics | Fraud & Security Intelligence | SAS Events
SAS Poland 0
SAS® Visual Investigator – the new dimension of use of advanced SAS analytics

Today, fraud detection in the areas of financial services, citizen services and national security is becoming an increasingly relevant challenge for both private organisations and government agencies. The ubiquity of the internet, the e‑commerce boom and growing volumes of data processed in clouds necessitate the implementation of advanced IT tools.

Analytics
Jon Lemon 0
Four-step approach to government fraud detection

Every day there are news stories of fraud perpetrated against federal government programs. Topping the list are Medicaid and Medicare schemes which costs taxpayers an estimated $100 billion a year. Fraud also is rampant in other important federal programs, including unemployment and disability benefits,  health care, food stamps, tax collection,

Analytics | Fraud & Security Intelligence
John Stultz 0
Is predictive analytics misguiding your fraud detection efforts?

When it comes to fraud detection and risk mitigation, predictive modeling has earned a reputation as the “heavy hitter” in the realm of data analytics.  As our celebration of International Fraud Awareness Week continues, I would challenge our readers to ask themselves this question, “Is the reliance upon predictive analytics

Ross Kaplan 0
The value of outside information

Most health care organizations either intentionally or due to some inability don’t use outside information (not just referals) in their search for fraud.  There are great numbers of valid reasons for this: HIPAA, security, usable/current data sources, inflexible information systems or processes, restrictive compliance & IT departments, and the list

Data for Good
Ross Kaplan 0
Health care fraud is on the rise

In the health care field, the impact of fraud, waste and abuse on payers -- whether insurance companies, government agencies or self-insured employers -- is enormous. Fraud losses weaken a payer’s financial position, with fraud loss estimates rivaling net income. Fraud losses feed the escalating care cost curve, undermining a