Fraud, waste, and abuse (FWA) in healthcare cost the industry billions each year, diverting resources from patient care and driving up premiums. Detecting FWA is not just about identifying anomalies; it involves navigating complex systems, vast data volumes, and rapidly evolving schemes. Traditional methods often fall short, leaving health plans vulnerable to sophisticated tactics that erode trust and financial stability and wasting precious resources on manual reviews that bear no fruit. As fraudsters leverage advanced technology, exploit loopholes, and adapt rapidly, health plans must stay ahead by adopting cutting-edge solutions and proactive strategies. A multi-faceted approach is critical for effective FWA detection and prevention.
Fraud, waste, and abuse (FWA) in healthcare cost the industry billions each year, diverting resources from patient care and driving up premiums. Detecting FWA is not just about identifying anomalies; it involves navigating complex systems, vast data volumes, and rapidly evolving schemes. Traditional methods often fall short, leaving health plans vulnerable to sophisticated tactics that erode trust and financial stability and wasting precious resources on manual reviews that bear no fruit.
As fraudsters leverage advanced technology, exploit loopholes, and adapt rapidly, health plans must stay ahead by adopting cutting-edge solutions and proactive strategies. A multi-faceted approach is critical for effective FWA detection and prevention.
