Payers
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Claims Management & Fraud Prevention

Enable prospective claims analysis and retrospective investigation and recovery by detecting and deterring fraudulent, erroneous, and abusive claims.

Solutions:


Detection Software
Ingenix Detection Software solutions help payers prevent inappropriate medical expense payouts and feature facility and professional claims editing capabilities, subrogation detection, and a table-driven knowledgebase of edit rules.
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Investigation and Recovery Services
Avoid overpayment of claims with our combination of prospective detection and investigation services which discover errors before the claim is paid and retrospective fraud and abuse services, including expert evidence analysis, interviewing, medical records review, and case documentation to help you recover your losses.
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