Using Analytics to Drive Payment Integrity and Reduce Fraud

Presented by

Ricky Sluder, CFE, Principal Solution Architect, SAS

About this talk

Today’s government and commercial health care market is in a constant state of change. Both government agencies and private insurers need to bring value through more effective claims, clinical targeting and revenue optimization. And payers are looking for single-source system that delivers an innovative, broad spectrum of services to fill gaps in their existing processes and improve outcomes. During this session we’ll look at a payment integrity approach that delivers results. We’ll also share case studies to show how you can use analytics to create measurable financial impact for both government and commercial payers and providers. We’ll review four key disciplines, including: Data management Claims analytics Behavioral analytics Clinical targeting

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