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Monday, October 5, 2015

2:00 p.m. - 2:30 p.m.
Track: Life, Health and Specialty View Track

A COLLABORATIVE APPROACH TO REAL-TIME FRAUD DETECTION

Mukundan K. Agaram, Chief Enterprise Architect, DELTA DENTAL OF MI, IN, OH

Traditional methods for fraud, waste and abuse identification employ backend data analytics applications and “pursue and recover" strategies, in which recovery ratios are low, to recoup fraudulent or excessive payments. This presentation explores hybrid collaborative approaches to provide dramatic operational efficiencies and optimal claims utilization.

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