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Fraud Detection and Prevention Tools

Medical fraud is a significant issue, internationally and regionally. Exact numbers are difficult to estimate, because not all fraudulent activities are discovered or shared with a centralized source by the affected organizations, however the losses may sum up to an excess of US$1 billion per year in the GCC because of medical fraud and abuse.

Acorn is a pioneer in developing fraud detection tools for more than a decade now and is currently developing advanced predictive analytics with AI.

Medical Fraud and Errors results in higher costs for patients, cuts into profit margins of payers, and wastes government investments that are meant to improve the healthcare system.

Our solution is a fraud prevention tool based on big data and analytics. This is the most effective way to prevent fraud and abuse even before claims are paid.

Predictive analytics has the ability to identify patterns that are potentially fraudulent and then sets rules to flag certain claims. The way how this works is with the use of artificial intelligence (AI) in the fraud detection software which will continually analyze data to identify more fraudulent patterns and create new rules for these patterns to be flagged.

Benefits of this tool are:

  • Costs savings and protection from medical fraud
  • Continues increase in fraud prevention through continues learning by the AI
  • Healthcare facilities and insurances maintain compliance with rules and regulations

Contact Us to learn more about the Fraud Detection and Prevention Tool and how it can help your organization save.