Business
CERIS Announces Enhanced Offering to Fraud, Waste, and Abuse Solutions
FORT WORTH, Texas, Aug. 27, 2024 (GLOBE NEWSWIRE) -- Today, CERIS, a CorVel Company, has announced advancements to its current Fraud, Waste, and Abuse (FWA)
About this update from Corvel Corp.
[{"type":"text","content":"FORT WORTH, Texas, Aug. 27, 2024 (GLOBE NEWSWIRE) -- Today, CERIS, a CorVel Company, has announced advancements to its current Fraud, Waste, and Abuse (FWA) solutions, including earlier detection capabilities and improved behavioral analytics. These new integrations and services will expand on CERIS’ current FWA offering for customers as they navigate a complex healthcare industry and work to better manage and mitigate prevalent fraud and risk issues in today’s landscape. Through identity and behavioral analytics, scanners, dashboards, reporting, and FWA consulting, CERIS’ enhanced solutions are automating detection and errors in billing to aid payers in prevention and remediation. The National Health Care Anti-Fraud Association (NHCAA) estimates that financial losses for healthcare organizations are in the tens of billions of dollars each year. A leader in payment integrity, CERIS works closely with providers to overcome challenges and false payment methods through its FWA products. Today’s enhancements will support the following: Fraud Case Analytics - SIU and Suspicious Activity Lead Services: Case data analytics will utilize client and industry data for rapid analysis and reporting through machine learning capabilitiesFraud Scanners: A suite of data scanners will detect suspicious activity on pre- and post-pay claims offering clients lead detection for Fraud, Waste & AbuseFraud Dashboard & Reporting: CERIS will offer flexible reporting options on client analysis and results through industry standard toolsFWA Consulting: CERIS will bring its expertise in prevention, remediation, and operational efficiencies of payment processing in support of Fraud, Waste & Abuse management “With today’s new advancements across FWA, CERIS is excited to support the entire enterprise, from workers’ compensation, government payments to group health, and beyond,” said Mark Johnson, Senior Vice President, Product Development at CERIS. “These enhancements will automate fraud, waste, and abuse detection within claims data through solutions that are completely customizable for CERIS customers. We are able to bring in disparate data sets – across medical claims and beyond –for customers who are eager and committed to preventing fraud across their organization.” Over the past twelve months, CERIS analyzed over 1.1 billion claims, and from this set, 1.6...