Case Study

Addressing the Dynamic Nature of Fraud with Machine Intelligence

Addressing the Dynamic Nature of Fraud with Machine Intelligence

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CASE STUDY UnitedHealthcare (UHC) is one of the world’s largest healthcare insurance companies, processing more than one half trillion dollars in gross billed charges in 2016, processing more than 750 billion digital transactions annually. Fortune Magazine has named the company to its Most Admired list for seven consecutive years. Challenges Healthcare fraud, waste, and abuse costs exceed hundreds of billions of dollars annually in the U.S. Payers like UHC are consistently challenged to identify new patterns of aberrant behavior, requiring many analysts to compare reports from different sources before they can confirm a new trend. This allows sophisticated fraudsters to rapidly evolve their strategies and outpace current detection models. Current fraud detection models are p

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