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Fraud and Abuse

Cure Claims Processing Ailments

Featured Case Study: Medicaid Claims Integrity Application
A system integrator is using Actian DataRush in support of a state agency contract to ensure that healthcare claims are paid correctly, and that Medicaid benefits enrollees meet qualifying criteria.
Actian Big Data Case Study
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Solutions based on Actian Big Data & Analytics software help healthcare organizations save money, improve the quality of care, and operate more efficiently by removing performance bottlenecks in areas such as claims processing and enabling timely analytics of vast data stores.

Data volumes and costs continue to skyrocket while the number of healthcare governance and compliance requirements expands each year. Duplicate tests and payments, benefits coordination issues, billing errors, abusive provider billings, and more contribute to hundreds of billions of dollars of overpayments in healthcare in the U.S. alone.

Bottlenecks also exist in drug discovery. Iteration and experimentation are the keys to advancement. Actian Big Data & Analytics software helps speed up analysis and reduce time to market for new drugs and treatments while easing the governance and compliance burden.

 

 

Actian Big Data & Analytics software solutions generate business value by providing a scalable, high-throughput platform to efficiently process and analyze large data sets.

  • Verify eligibility
  • Detect duplicate claim records
  • Catch fraud before payment occurs
  • Recover revenue
  • Prevent errors or delays in care
  • Extract knowledge from massive amounts of data quickly

Accelerating Big Data 2.0™