The majority of health insurers’ fraud, waste and abuse (FWA) investigations take place after claims are paid, not before — and consumer payments can be a particular point of vulnerability.
Artificial intelligence (AI) can help healthcare companies tackle those vulnerabilities and battle the fraudsters, as PYMNTS found in the latest “AI in Focus: The Healthcare Technology Roadmap” report, done in collaboration between PYMNTS and Brighterion.
Read more: AI in Focus: The Healthcare Technology Roadmap
We’d love to be your preferred source for news.
Please add us to your preferred sources list so our news, data and interviews show up in your feed. Thanks!
Of the 100 healthcare executives surveyed, 71% plan to invest in AI technologies over the next three years to aid them in their efforts to combat FWA. One-hundred percent of those with more than $1 billion in annual revenues plan to invest in the technology, as do 89% of those with annual revenues between $100 million and $1 billion.
The technology can help sift through large volumes of provider and customer payment-related data in real time, flagging potentially risky claims long before they are paid.
About 95% of the firms surveyed said the technology has a high degree of accuracy in detecting FWA. As many as 97% of respondents said it is very or extremely important for an AI tool to adapt to changing behaviors evident in claims data.
Advertisement: Scroll to Continue
Read more: AI in Focus: The Healthcare Technology Roadmap
Add as Preferred Source
