ISO MedSentry®

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.

Property/casualty insurers lose $30 billion a year to medical provider fraud, waste and abuse

Iso Medsentry Thumbnail

Property/casualty insurers lose $30 billion a year to medical provider fraud, waste and abuse

What You Can’t See Can Hurt You: The Unseen Problem That’s Costing Insurers Billions

Predictive analytics help detect and stop healthcare fraud, waste, and abuse

Predictive Analytics

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.

Empowering Insurers to Stop Medical Fraud

Empowering Insurers

Empowering Insurers to Stop Medical Fraud

Learn how ISO MedSentry reduces your medical billing exposure.

Icon Action Take decisive action against suspicious medical providers
Icon Prioritize Exposure Prioritize exposure associated with specific medical providers
Icon Analyze Injury Analyze injury claims more accurately
Icon Process Bills Process legitimate medical bills quickly

Clients have experienced significant savings with ISO MedSentry

Case Study Thumbnail

Clients have experienced significant savings with ISO MedSentry

  • 71% average reduction in medical billing
  • 69% decrease in billing from suspect medical providers

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.

For more Verisk claims fraud solutions, check out:

Fast-track meritorious claims while improving fraud detection

Iso Claimsearch

Fast-track meritorious claims while improving fraud detection

ISO ClaimSearch® is more than the world’s largest database of property/casualty claims—it’s also a robust claims intelligence platform. Its claims-matching technology is an essential first step in fraud detection, and the results can help facilitate fast-tracking. The platform also provides seamless access to integrated claims fraud-detection and investigative analysis tools.

Detect claims fraud quickly and accurately with predictive analytics

Claimdirectore V2

Detect claims fraud quickly and accurately with predictive analytics

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.

Fight organized insurance fraud with advanced link analysis

Netmap

Fight organized insurance fraud with advanced link analysis

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.

Get missing details to complete claims

Dnet2

Get missing details to complete claims

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.

Improve investigation case management and eliminate inefficiencies

Case Manager

Improve investigation case management and eliminate inefficiencies

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.

Contact Us to Learn More

Other Ways to Connect

We are available Monday through Friday, 7 a.m. — 9 p.m. US Eastern Time:

  • Chat Now

    Note that password resets and user information are not available through Live Chat or Email. Instead, please call the main toll-free number below.

  • Main Toll-Free: 1-800-888-4476

  • Global Toll-Free: International Access code, then 800 48977489
    When calling from the UK, please dial 00 800 4897 7489

For service or support

Get all the information you need in one place—from customer support to sales, operations, and more.