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Most people know that FICO has leading analytic capabilities in financial services. We help businesses reduce fraud, manage claims, drive collection results, improve risk management and use data to model and predict uptake for complex marketing offers and service plans.
Fewer people know that FICO also provides analytic solutions and scores that improve patient behaviors, drive medication adherence, and can enable you to increase the quality of care to ensure patients and customers achieve great outcomes. We also provide a decision management platform that allows you to tackle emerging data and analytic problems that often require strict regulatory compliance. Using the latest in data science, machine learning and advanced analytics, your organization can increase customer engagement where needed and make great decisions to improve your profitability, drive efficiency in your operations and achieve business results.
GEHA catches fraud before payout while improving case targeting twelve-fold.
FICO® Propensity Scores for Healthcare can improve patient engagement for all the stakeholders in their care and treatment — including payers, providers, hospitals, retail pharmacies and pharmaceutical manufacturers. Predicting the propens...
“My special investigations unit keeps an eye on fraud and abuse, but what
The line between fraud and waste may be a fine one, but when you’re convinced
that a dubious claim is not fraudulent, does your payer organization h...
Many insurance payers realize how valuable identity resolution and link analysis technology can be in supporting detection of organized crime, as well as opportunistic fraudulent providers. But they also know how difficult it is to impleme...
It’s a fact: Accounts receivables and bad debt are soaring among hospitals and health systems, and it’s not just because of uninsured patients. Unpaid medical bills are also surging at an alarming rate for many middle-class citizens, due t...