Healthcare Solutions
4L Data Intelligence healthcare solutions are powered by patented Integr8 AI™ technology in combination with our proprietary healthcare provider database of over 8M NPI's. All solutions are cloud-based and integrate with any workflow to get immediate quality and financial improvement without ripping-and-replacing legacy systems.
Healthcare Solutions
4L Data Intelligence healthcare solutions are powered by patented Integr8 AI™ technology in combination with our proprietary healthcare provider database of over 8M NPI's. All solutions are cloud-based and integrate with any workflow to get immediate quality and financial improvement without ripping-and-replacing legacy systems.
Provider Integrity Edits | Adaptive Claims Edits
Billing Behavior Analytics | Provider Scheme Analytics
Use the power of Integr8 AI™ to find, fight and prevent fraud, waste and abuse fast with our revolutionary provider-centric FWA approach.
- Detect the fraud, waste, and abuse you can't see now with claims data-centric approaches
- Rapidly detect and prevent FWA at five points across the claims management workflow
- Reduce overall cost-per-claim
- Dynamically and continuously understand provider behaviors, relationships, and outlier status
- Continuously and automatically identify and accurately pay and incentivize 'good' providers
Prevent FWA At 5 Points Across The Claims Workflow
The only patented fraud, waste, and abuse prevention technology that automates the power of Integr8 AI to deliver dynamic, fast, actionable, and accurate provider-centric detection and documentation at five points across the claims and network management workflow.
Find and Fight Fraud Fast™
The 4L FWA Prevention solution gives fraud leaders and their teams the power of Integr8 AI to solve each of these three big problems:
1) They can’t find fraud and collusion fast enough.
2) Investigations take too long.
3) True positive rates are not high enough.
- Detect the fraud, waste, and abuse you can't see now with claims data-centric approaches
- Rapidly detect and prevent FWA at five points across the claims management workflow
- Automate SIU-in-a-box detection and documentation to enable rapid action
- Increase fraud lead generation and true positive rates with patented technology platform
Provider Data Management | Provider Integrity Maintenance | Continuous Monitoring and Alerts
Ninety-three continuously updated and validated provider demographic, directory and integrity data elements, combined with the power of Integr8 AI™, enables continuous provider credentialing and claims analysis to elevate data, provider, and payment integrity.
- Proprietary provider database has 93 unique provider data elements for over 8M NPIs
- Unique provider data elements are double or triple source validated
- All provider data elements are independent of provider-provided data to ensure integrity
- Continuous data monitoring enables near real-time alerts on critical data changes
- Easy to use, permission-based dashboards make managing provider data easy for staff
- Snowflake enables easily accessible weekly or monthly updated master data file access
