AI Potentetial: Cost Savings In Payment Integrity KISACO RESEARCH Leveraging AI in Healthcare Payment Integrity Download Report AI For Fraud Detection: A Paradigm Shift The escalating complexity of healthcare fraud, waste, and abuse (FWA) behaviors and schemes demands a paradigm … Read More
Author Archives: tmorley
Revolutionizing Healthcare Payment Integrity with AI
KISACO RESEARCH Revolutionizing Healthcare Payment Integrity with AI Download Report In the ever-evolving landscape of healthcare payment integrity, a new approach is emerging that promises to revolutionize how we detect and prevent fraud, waste, and abuse (FWA). Our latest report, … Read More
NAMPI 2024: Provider-Centric FWA Prevention
NAMPI 2024 Breakout session Provider-Centric FWA Prevention: The Value of Seeing Every Behavior, Pattern, Outlier & Relationship in Near Real-Time Watch on youtube Medicaid Program Integrity depends on having a continuous in-depth understanding of provider behaviors, patterns, outliers, and relationships … Read More
4L Data Intelligence Featured in The Self-Insurer Magazine
The Self-Insurer Magazine Combating Sophisticated Healthcare Fraud Schemes: Lessons for Self-Insured Health Plans Read Article 4L Data Intelligence, a leader in healthcare fraud prevention technology, is proud to announce that our Senior Fraud Advisor, Greg Lyon, has authored a featured … Read More
Educational Webinar in NHCAA’s Virtual Training Program
LIVE WEBINAR 4L Data Intelligence Delivers Educational Webinar on Early Detection of Provider Collusion Schemes in NHCAA’s Virtual Training Program Watch NOW We’re pleased to announce that 4L Data Intelligence recently participated as a partner speaker in a webinar hosted … Read More
Stopping the Tsunami of Telehealth Fraud, Waste and Abuse
By Theja Birur Surfers talk a lot about sets, groups of waves that keep coming one behind the other. While that may be a surfer’s dream, the continuous cadence of telehealth fraud, waste and abuse stories is looking more like … Read More
Study Showed 10% Of Workers Comp Claims Paid Were Fraudulent
A 2021 4L Data Intelligence analysis of over four (4) million workers compensation claims paid showed that 19,612 providers out of a network of 86,000 submitted fraudulent claims totaling about 10% of all claims paid during the prior year. This … Read More
Stopping The Catheter Fraud Scheme
case study – GREG LYON Unmasking a $2 Billion Catheter Fraud Scheme: Lessons for Healthcare Payers Greg is a recognized anti-fraud expert with experience in Financial Services and Healthcare Payments that includes serving as Director of Fraud Prevention at United … Read More
Adopting AI Combats FWA And Overpayments
Lately, it seems like everyone is either excited or worried about artificial intelligence (AI). Programs like ChatGPT are seemingly able to replicate human writing and speech patterns and can create new bodies of text based on simple (or not-so-simple) prompts. … Read More
4L Data Panel: Improving Payer and Provider Value Using AI
SAN RAMON, Calif. – Oct. 23, 2023 – 4L Data Intelligence™, the leader in patented AI-powered contextual claims analysis for fraud, waste, and abuse (FWA) prevention in healthcare, today announced it’s hosting a panel discussion titled “Improving Payer and Provider Value … Read More
