InCompliance® AI based Fraud, Waste and Abuse Detection Solutions
Introducing for the First time in the Middle East, InCompliance® Payment Integrity Platform that gives healthcare payers and health authorities an enterprise-class solution to reduce erroneous claims. InCompliance has been developed and refined using healthcare data sets from the region and not elsewhere. This makes InCompliance® unique and effective.
InCompliance® is an advanced AI-powered solution designed to help health authorities and payors detect, prevent, and address fraud, waste, and abuse (FWA) in healthcare systems. By leveraging cutting-edge machine learning and predictive analytics, InCompliance® empowers organizations to safeguard resources, ensure compliance, and promote financial sustainability in an increasingly complex healthcare environment.
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From manual clinical coding audits to an advanced AI powered FWA solution, we have a sound knowledge of the anomalies in claims.
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A snapshot of InCompliance® features are listed below
AI-Driven Detection
Identify patterns and anomalies in claims and billing data to detect potential FWA cases with unparalleled accuracy.​​​​​​​​​​
Comprehensive Case Management
Provide tools for tracking, analyzing, and resolving suspected FWA cases, streamlining investigation workflows.
Integration with Existing Systems
Seamlessly integrates with claims management and financial systems for end-to-end FWA prevention.
Predictive Analytics
Use advanced algorithms to forecast high-risk areas, enabling proactive measures to mitigate fraud and inefficiencies.
Customizable Rules Engine
Tailor detection criteria to specific regional and organizational policies, ensuring precise alignment with compliance requirements.
Real-Time Monitoring
Continuously analyze transactions and activities, flagging irregularities in real time to minimize financial losses.