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Healthcare Fraud Shield Launches FWA360Leads, Enabling Healthcare Insurance Companies to Automatically Identify Fraud, Waste, Abuse, and Error Schemes


News provided by

Healthcare Fraud Shield

Jan 25, 2024, 09:00 ET

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FWA360Leads Eliminates Manual Analytics – Significantly Saving Time and Reducing Cost

CHESTERFIELD, Mo., Jan. 25, 2024 /PRNewswire/ -- Healthcare Fraud Shield (HCFS), a leading provider of fraud, waste, abuse, and error (FWAE) protection solutions for the healthcare insurance market, launched FWA360Leads®, a new product that automatically identifies and prioritizes FWAE leads based on order of importance and impact severity.

The HCFSPlatform™ is the backbone of many top healthcare insurance companies' FWAE & payment integrity strategies – delivering millions of dollars in savings, recoveries, and prevented losses each year.

Healthcare insurance companies have limited resources and time to identify, qualify, and accept new FWAE leads as either pre-pay reviews or post-pay cases. HCFS developed FWA360Leads® to eliminate this pain by automating lead detection.

A major functional addition to HCFS's FWA Precision Engine™, FWA360Leads® allows leads to be detected, presented, reviewed, and accepted in the typical workflow of a healthcare plan. Leveraging AI models to make this happen along with machine learning, HCFS receives user feedback and then automatically recalibrates the lead feed. Prioritization is measured by mapping these response behaviors alongside our industry-standard library of alerts.

"We're thrilled that early adopters of FWA360Leads® reported high ROI from the product," said Karen Weintraub, EVP, HCFS. "Namely, they are now able to both eliminate tedious manual analytics and identify new important leads they would otherwise have likely missed. This product represents the ongoing evolution of HCFS, always seeking to leverage the latest technological innovations in pursuit of protecting our customers from FWAE and providing them millions in savings that they would otherwise never achieve."

Business benefits include:

  • Higher value leads combining the power of Artificial Intelligence and HCFS library of over 1,200+ medical alerts.
  • Use of machine learning reducing false positives, increase precision and accuracy.
  • Increased efficiency by using less resources and increasing savings.
  • Proactively and prioritizes greatest risks through early detection using pre-payment
  • Identified insights create immediate actionable intelligence through pre-payment, provider education, audit, and case prioritization.

For more information, please visit www.hcfraudshield.com.

About Healthcare Fraud Shield

Healthcare Fraud Shield provides new and unique Fraud, Waste, Abuse, and Error (FWAE) automated solutions to the healthcare industry. Our exclusive data solutions and investigative expertise deliver maximum results in the detection and prevention against fraud, waste, abuse, and error for payment integrity and special investigation units. Leveraging our comprehensive fraud, waste, abuse, and error detection experience, we deliver fresh insights and new approaches to combat the largest challenge of our time - the delivery of honest, efficient, and compassionate healthcare.

Media Contact:
Tony Rademeyer
Healthcare Fraud Shield
1-888-333-8140
[email protected]

SOURCE Healthcare Fraud Shield

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