Healthcare insurance

FICO predictive analytic solutions improve financial performance, optimize quality of care, and manage risk.


Around the world, a multitude of factors influences the quality and cost of healthcare. There are challenges for both payers and providers.  For payers, two things are certain to rise: patient expectations, and the drive to improve operational efficiencies. Providers share two common goals: to provide the highest quality care, and reduce the costs of delivering it. FICO helps providers to achieve both goals with a range of products that leverage decades of innovation in predictive analytics, and 15 years of experience in the health care industry.

In either case, payers or providers, FICO offers predictive analytic solutions. For providers, FICO solutions improve financial performance, optimize quality of care, and manage risk, while payers solutions minimize errors, fraud and abuse and optimize customer experience.


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FICO healthcare fraud analytics uncover vast savings for Highmark

Highmark, Inc. a leading Pennsylvania health insurer, is dedicated to identifying potential losses from fraud, abuse and errors in claims processing.  But its dedication is not just in principle - it's in action.  By taking a leadership role in adopting advanced analytic scoring models, today Highmark has impressive numbers to show how much that dedication is paying off.  

Read more about the partnership between Highmark and FICO to take advantage of two types of FICO analytic scoring models within FICO Insurance Fraud Manager to improve its fraud and abuse detection.