ISO MedSentryTM is the industry’s first integrated model to detect medical fraud. ISO MedSentry combines the strength and efficiency of advanced analytics with the quality and vigor of our clinical experts’ analyses to set a new standard in the early detection of fraud.
Medical fraud: A critical problem
Medical fraud has become increasingly problematic for property/casualty insurers. Multiple streams of information sources — such as claimant histories, medical billing data, and provider paperwork — create an environment in which greater and more sophisticated medical billing ploys can flourish.
To fight those evolving schemes, ISO created ISO MedSentry, a system that puts the power back in the hands of individual insurers.
A new standard in medical fraud detection
ISO MedSentry is the first tool to integrate highly advanced analytical tools with a clinically expert, human-touch validation process — offering accurate, timely, and effective results.
ISO MedSentry provides insurers with reliable, specific, and actionable cases. As evidenced by its 90 percent referral acceptance rate, the system helps you avoid the delays and costs associated with false positives, which can be a huge burden on already-strapped SIU resources.
How it helps
- The combined “high-tech, high-touch” approach identifies medical billing fraud at the source in the earliest stages of the process.
- The breadth and depth of our analysts’ experience improve the quality of referrals and saves SIUs time and effort in their initial investigations.
- ISO’s proven experience with big data analytical systems and knowledge of property/casualty claims processes ensure precise, accurate results and the safety and security of client data.
- SaaS (software-as-a-service) technology allows flexibility through customization and ensures more effective investigative resource deployment.
- Discover pockets of fraud risk in your own medical billing data that might otherwise go undetected.
- Prioritize exposure associated with specific medical providers to increase productivity.
- Receive actionable case reports that facilitate fast, effective investigations so you can close a greater amount of cases.
- Avoid the delays associated with false positives.
- Use information from the ISO MedSentry process to improve your ability to analyze claims accurately and process legitimate first-party medical bills quickly.
Get started now
Find out how ISO MedSentry can help you win the fight against medical fraud.
- Phone: 1-800-888-4476