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With FICO® Insurance Fraud Manager, health care payers are empowered to quickly stop fraud, waste and abuse before or after payment, ending the vicious cycle of “pay and chase.”
This paper focuses on waste in health care payments, providing specific examples and their detection by Insurance Fraud Manager. Based on industry-leading adaptive predictive analytics, this FICO solution automatically senses and identifies emerging FWA patterns, detecting up to 47% more fraud.