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Reducing fraud, waste and abuse in health care by using a big data analysis is a great benefit for healthcare organizations because the main contributor to raise healthcare costs in the United States is the cost of fraud, waste and abuse in the healthcare industry. Health Analytics Solutions in UK can be a game changer for all these problems. The Centers for Medicare and Medicaid Services reduced over $ 210.7 million in health care fraud over the course of a year using predictive analyzes. United Health Care testing predictive analyzes to identify false statements in a systematic and repeatable manner and generated a 2200% return on their big data.
The main thing to detect fraud is the ability to record and analyze historical data and large unstructured databases of historical claims and use machine learning algorithms to detect irregularities and patterns.
Health care organizations can analyze patient records to detect irregularities such as overuse of services in less time, patients receiving health care services from different hospitals in different locations simultaneously or the same prescriptions for the same patient in several locations.
A major health care provider has exploited a data lake approach because it has combined huge amounts of data as a data center for several departments, including fraud prevention. With best Data Visualization Solutions in UK the provider is on the way to capturing an additional 20% of fraud, waste and abuse in its claims department.
The Centers for Medicare and Medicaid services use predictive analyzes to give risk scores to specific receivables and suppliers, to identify billing patterns and claims that are difficult to detect by previous methods. Rule-based templates mark certain loads automatically. Irregular models increase doubts, based on factors that seem unconvincing. Predictive models compare charges against a fraud profile and increase suspicion. Graphic models raise suspicions based on supplier relationships; fraudulent billers are often organized in the form of narrow networks.
Bilytica provides the best BI Consulting Services in UK to its customers and helps them to be more efficient, secure and successful in the industry.