Identify medical provider fraud quickly and accurately
Insurers need to detect unethical medical billing practices early to reduce claim leakage and process legitimate bills faster. ISO 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.
Predictive analytics help detect and stop healthcare fraud, waste, and abuse
ISO MedSentry applies advanced analytics to your medical bills and provides a risk score for every medical provider in your book of business. It then produces a report detailing specific issues in your billing data as well as clinical analysis that describes the suspect behavior and what to investigate.
Save time, effort, and expense investigating medical provider fraud
By detecting medical fraud early and at the source, ISO MedSentry helps SIU professionals, medical management, and claims teams:
- Take decisive action against suspicious medical providers
- Prioritize exposure associated with specific medical providers
- Analyze injury claims more accurately
- Process legitimate medical bills quickly
Easy implementation delivers substantial ROI
As a SaaS solution, ISO MedSentry requires minimal IT lift, and customers have realized ROI of 10:1 to 20:1.