Suspect Claims Detection

SAS® OnDemand: Suspect Claims Detection

Optimize auditor time and reduce service costs

Identify suspicious claims and service providers by analyzing service claim data. Focus your auditors on the most likely sources of fraud by using dozens of automated analytic models built on the SAS Fraud Framework. The SAS Cloud Analytics delivery method gives you fast business results with minimal IT investment, distributed predictably over time.

Benefits

Reduce service costs.

Greatly reduce your service costs by denying or charging back for illegitimate claims. And once service providers are aware they are being monitored, they will be less likely to submit illegitimate claims in the first place.

Improve service network effectiveness.

Automated claims review processes uncover patterns of inefficiency, enabling you to improve performance and boost end-user satisfaction by proactively addressing issues. In addition, you can maximize the effectiveness of your auditors by enabling them to focus on the claims and service providers with the highest probability of fraud.

Analyze and optimize parts usage.

Automated analytics detect patterns of parts usage that can be utilized to retrain technicians and save parts costs.

Get up and running quickly.

The solution is hosted on a secure, shareable and scalable infrastructure specifically designed to detect suspect claims – without the up-front IT investment, staff and maintenance costs.

Screenshots

Features

Suspect Claims Detection
  • Scoring.
  • Data and text mining with predictive models.
  • Dispositioning.
  • Hosted solution.
  • IT and analytics expertise.
  • Flexibility.

Technical Information

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