Medical provider fraud, waste, and abuse are major issues for insurers. Quickly discover fraud schemes in your book of business with MedSentry®, an advanced lead-generation tool that leverages aggregated industry data and predictive analytics.
Learn how a top 10 insurer used MedSentry to uncover over $170K in questionable bills from a physical therapy practice.
MedSentry is part of a full suite of claims solutions that provide compliance, claims development, and deeper fraud analysis and tools.
With MedSentry, SIU managers can empower their teams to know which providers to investigate and why. The simple solution helps vet leads and improve referrals. And it helps managers articulate ROI with several tangible success metrics.
Investigators can get qualified leads backed by specific issues to investigate. The solution helps you devise investigative plans, launch factual examinations, and develop questions for interviews, examinations under oath, and depositions.
Analysts can quickly identify which providers to focus on in their book of business and compare them to peers. The tool analyzes massive amounts of providers to spotlight outlier trends and patterns of practice, including high exposures and emerging schemes.
The solution applies more than 100 advanced analytic models to your medical bills. It provides a risk score for every medical provider in your book of business and specific issues with each provider scored.
Learn how MedSentry helps reduce your medical billing exposure.
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