ISO MedSentry® is the industry standard for fighting medical provider fraud. As part of the ISO ClaimSearch® portfolio, ISO MedSentry uses Software-as-a-Service (SaaS) technology to provide a flexible, accurate, and quick solution for detecting fraud, waste, and abuse in medical billing data. By combining sophisticated data analysis with expert clinical review, ISO MedSentry:
- supports the work of special investigation units (SIU), medical management, and claims teams
- eliminates false positives
- saves insurers significant time and money
How does ISO MedSentry work?
Using the insurer’s medical provider history and weekly incremental files, ISO MedSentry begins an investigation of provider billing data by applying automated analytical tools to identify possible suspect providers. Suspect cases are then sent for expert clinical analysis.
ISO MedSentry compiles the information as a referral for the insurer’s team(s) to download and review. It’s that simple.
Contact Shane Riedman to learn more about how easy it is to integrate ISO MedSentry into your workflow.