Never before has the financial efficiency of healthcare delivery been more important. Delivering a high quality clinical outcome in a cost effective manner is paramount in today’s environment of rising costs, competition, and legislated demands. A key to this challenge is the successful identification, validation and resolution of fraud, waste, and abuse.

To aid its healthcare clients, MedAssurant provides a sophisticated solution focused on fraud, waste, and abuse. Referred to as Claims Integrity™, this advanced system derives unique analytical power from a dataset of more than 2.5 billion medical events from more than 99% of counties across the United States – a depth, breadth, and richness of insight and healthcare practice intelligence that is unmatched in the industry. Peer group matching, advanced signal strengthening, and ongoing feedback systems are but a few advancements that drive the sophistication of the MedAssurant Claims Integrity™ solution. On top of the advanced signal detection systems is a comprehensive validation process – able to not only confirm fraud, waste, and abuse signal findings, but also hone sensitivity, improve claims accuracy, and power insight into root causes – thereby enabling both financial improvement and proactive prevention.

> Solution Highlights
> Superior Approach
> Focus On High Return-On-Investment
> Comprehensive Project Management and Transparency
> Seamless Integration, Refreshes and Data Transfers
> Coordinated Solutions Bringing Synergies and Expanded Value
> Broad Experience and Nationwide Infrastructure
> Superior Medical Case Validation Capabilities
> Focus On Quality Control and Oversight
> Quality Beyond Process
> Financial Insight and Results