Increase Profits with Claims Optimization & Fraud Detection
Rising costs of managing claims and risk combined with the struggle to increase profitability are some key challenges in the insurance industry. Property, casualty, health and benefits insurers have limited underwriting and investigative resources to analyze, review, assess and pay claims. The industry also faces competitive pressures to build new business, retain current customers and meet customer satisfaction requirements.
How can insurers decrease costs, increase the number of new policies and make their current policies more profitable? The answer is clear. Using the wealth of data that resides in their various transactional and operational systems, combined with predictive analytics, they can place themselves on the leading edge of insurance technology and address key business issues.
Insurance companies need to be constantly wary of fraudulent claims and abuse too. Fraud deterrence and abuse detection technology save insurers millions of dollars every year. Predictive analytics models are capable of detecting subtle patterns of unusual activity, allowing insurers to improve detection of claims fraud and abuse by quickly detecting, documenting and expediting investigation of suspect providers, claimants and claim-level behavior. All of these models can be done through Angoss predictive analytics software and solutions.
Angoss Software and Solutions for insurance allow organizations to:
- Build models based on actual cases and anomaly detection models
- Proactively detect claims fraud for health, dental and prescription drug claims
- Identify new kinds of fraud—often before the organization is aware they have occurred
- Create prioritized claims lists and targeting tools that support effective fraud and abuse strategies focusing on providers, claimants and claims that are most likely abusing systems and programs
- Detect post-payment and pre-payment instances—enabling analysis of past incidents and automated detection of new claims
- Acquire new customers and increase market share