FraudScope Announces Upgrades to its Proprietary Case Management and Reporting Technology
Summary
FraudScope, an AI-based platform that helps health plan special investigations units, payment integrity, and medical review teams investigate fraud, waste, and abuse (FWA), today announced it has made significant upgrades to its case management and reporting capabilities. The upgrades, which were driven by FraudScope health plan SIU customer needs, better enable teams to more efficiently and effectively collaborate across the organization and to open, investigate, and resolve fraud cases. “The fraud industry is constantly changing, and FraudScope is committed to evolving our offerings to provide our customers with unparalleled industry tools for identifying suspicious claims, gathering actionable data, and resolving cases quickly,” stated Musheer Ahmed, CEO of FraudScope. “Our customers have seen dramatic results with the FraudScope AI platform and we are determined to keep improving and expanding our capabilities to drive even better outcomes and enhance their experience.” FraudScope recently announced that it added more than 75 customer-driven enhancements to its platform in 2019, including new capabilities for facility and pharmacy FWA detection and investigation and a ‘collusion’ capability that helps plans identify cases where patients, providers, facilities and/or pharmacies are colluding to commit FWA. FraudScope’s AI platform with the case management enhancements and upgrades is available now.