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Special investigations units are experiencing new challenges with complex cases, increased fraud, and stringent regulatory requirements. Case Manager™ is a fully configurable fraud management solution that improves productivity and efficiency by automating triage, assignment, and compliance reporting.
Learn how the solution can lower expenses by simplifying investigations and vendor management.
Case Manager is an innovative platform that handles all your SIU operations from end to end. Its dynamic features help SIU managers:
Streamline case management with customizable investigative workflows
Eliminate mundane administrative tasks with AI-driven automations
Access data from ClaimSearch® or any third-party system through seamless integrations
Whatever workflows you need, Case Manager can conform—even for managing complex, multi-jurisdiction case investigations. The solution’s modern interface and digital Kanban tool make it easy to manage and prioritize your work. Plus, it’s a SaaS platform with minimal IT lift
Find out how Case Manager helps investigators achieve highly productive investigations through automated workflows and streamlined processes and compliance.
Insurers need to determine quickly and efficiently whether a claim is likely to be fraudulent—or if it can be fast-tracked for settlement. ClaimDirectorSM uses the power of predictive analytics to score claims with greater accuracy and reveal questionable attributes.
Insurers need to detect unethical medical billing practices early to reduce claim leakage and process legitimate bills faster. MedSentry® uses predictive analytics and expert clinical analysis to uncover fraudulent medical provider fraud in your billing data. It also delivers detailed reports to help guide investigations.
Discover the hidden connections among claimants, providers, and businesses to help identify organized insurance fraud. NetMap’s advanced analytics greatly enhance the SIU’s ability to discover fraud rings within their company’s claims. The software quickly evaluates claim information, public records, and other data to reveal patterns indicative of fraud.
Find the critical data you need at FNOL (first notice of loss) to help complete claims quickly and spot potential fraud. Decision Net® helps fill in the gaps with supplemental claims information from best-in-class sources. This extensive resource helps claims teams improve decision making, expedite meritorious claims, and increase the impact of SIU referrals.
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