Waste, Fraud and Abuse

SAS helps government organizations detect more fraud and increase investigator efficiency by automatically identifying potential fraud activity, prioritizing review cases based on severity, and providing investigation tools with pre-aggregated data so cases may be worked more quickly. By pulling data from multiple legacy systems and transforming it into actionable intelligence, SAS provides end-to-end capabilities for detecting and preventing fraud using a combination of business rules, advanced analytics and social network analysis techniques that identify suspicious activities across your organization:

• Identify fraudulent activity quickly and accurately. As transactions are processed across known business rules, new schemes are captured as they emerge. Use the knowledge your analysts currently have and match that with new activity to identify additional fraudulent cases – and enhance the rules in the process.
• Discover emerging suspicious activity. SAS provides advanced anomaly detection and predictive modeling techniques so you can score and prioritize suspicious activities, and thus detect fraudulent activity as it occurs, reducing the fiscal impact of a scheme's life cycle.
• Decrease fraud losses. With SAS' data integration capabilities, you can search multiple databases and various data stores and capture all fraud outcomes, referrals and systems for reuse. As a result, you'll be able to detect repeat offenders and more accurately score fraudulent activity, including staff data and audit records to identify and stop insider or collusive fraud.
• Reduce costs. SAS helps government organizations move from a "pay and chase" to a "predict and prevent" paradigm, opening the door to millions of dollars in cost avoidance. You can also leverage advanced investigation and case management tools to prioritize and identify higher value networks that will improve investigator efficiency.
• Improve transparency and increase accountability. SAS provides enhanced fraud management that satisfies regulatory requirements for program oversight and integrity.

• With a true enterprise view of fraud through a single entity view, you can significantly reduce costs while addressing fraud, waste and abuse across multiple program areas.
• An end-to-end solution combines best-of-breed data integration and data quality capabilities, sophisticated detection analytics and a user-friendly investigation interface to facilitate the entire detection, investigation and prevention process.
• Sophisticated detection analytics combines heuristic rules, anomaly detection, predictive modeling and social network analysis to effectively identify suspicious entities and activities and prioritize them for further investigation. Rapid detection allows for suspicious activities to be flagged for review before improper payments are issued.
• Social network analytics determine significant relationships between entities to identify fraud rings or collusive networks and holistically evaluate the activities of the entire network.
• An intuitive investigation interface allows investigators to quickly and easily review alerts and cases, access all supporting detail information and relationships, and take appropriate action – all from a single user-friendly portal.
• Continuous improvement is enabled through prepackaged models and detection analytics that are vendor-maintained and updated. Alert engine outcomes are fed back into the analytics engine to help fine-tune detection analytics over time and reduce false-positive rates.