NAMPI 2024 Breakout session
Provider-Centric FWA Prevention: The Value of Seeing Every Behavior, Pattern, Outlier & Relationship in Near Real-Time
Medicaid Program Integrity depends on having a continuous in-depth understanding of provider behaviors, patterns, outliers, and relationships in near real-time. Legacy provider credentialing and claims datacentric payment solutions are built on passive, rules-based platforms that can’t “see” dynamic changes in behaviors and relationships. This session will focus on a provider-centric FWA prevention approach. The 4L FWA Prevention solution is the provider-centric approach that utilizes patented Integr8 AI Risk Detection™ technology to detect dynamic changes in provider behaviors, relationships, patterns, and other anomalies to detect FWA activity that payers are universally missing with legacy technology and even claims data-centric AI approaches.
