Get equipped to fight claims fraud
10 percent of claims are fraudulent. Ready to stop the leakage?
Unmatched industry data and leading analytics are the core of Verisk’s comprehensive suite of anti-fraud solutions. It’s why we’re uniquely equipped to empower SIU to fight claims fraud with greater speed, precision, and efficiency.
Medical billing data is complex. That’s why it’s the perfect place for unscrupulous providers to hide fraud, waste, and abuse. Our provider fraud solution uses predictive analytics and expert clinical analysis to identify fraud in your medical billing data.
Want better results from your fraud analytics? Boost your organization’s models with out of-the-box, predictive mini-models developed from the industry’s most comprehensive loss history database.
Automated fraud analysis at FNOL not only identifies questionable claims early—it also helps expedite legitimate losses. Leveraging machine learning predictive models and 1.5 billion claim records, ClaimDirector accurately scores all incoming claims and provides reason codes to enhance investigations.
Straight-through processing is considered the holy grail of digital claims—where insurers can intake, process, and pay claims automaticallyRead the article
As insurers’ interest in artificial intelligence (AI) grows, we must not only embrace its immense capabilities but also work to mitigate its potential risks.Read the article
Photo-based claims estimates have been a growing trend the past few years in the insurance industry, and once the pandemic hit, that trend accelerated significantly.Read the article
Manage all investigative, intelligence, and regulatory functions from end to end with our fully configurable case management platform. The innovative solution helps SIU increase productivity and efficiency by using AI to automate routine tasks such as intake and triage, tracking, auditing, and compliance.
Sometimes a simple claim can be part of a larger fraud scheme. Our network analysis software helps you uncover hidden connections among claimants, providers, and businesses by analyzing 1.5 billion claims, plus vetted third-party data.