What is FraudLens?
FraudLens is the First Near Real-Time healthcare fraud, waste and abuse automated detection and prevention software solution that is specifically designed to reduce the financial burden caused by pre-payment of high volume, low dollar FWA (constituting more than 90% of all FWA) in addition to low volume, high dollar FWA.
FraudLens is an intelligent software solution that enables healthcare payers to increase savings significantly from fraud, waste and abuse (FWA) by moving from a decades-old “pay and chase” and “manual review” model to a smart, automated “detect and prevent” model. These new savings can be used to fund new initiatives.
How FraudLens Works?
FraudLens applies its Multi-Vectored technology comprised of miniature expert systems on all claims data every day. FraudLens reports within 24 hours (pre-payment & pre-adjudication) exactly who has committed FWA, what was fraudulent, when it happened, where it happened, and how it happened.