Fraud / Waste & Abuse Management / Analytics & Reporting
JBig for Analytics
With JBig's ready built assets for the health insurance data analytics your reports are more accurate. We provide ROLAP data models and consulting services to implement your health datamarts for future use by reports, predictive and prescriptive analytics, abuse waste and fraud management.
JBig Anomaly Detection
The first stage of fraud and abuse management is Anomaly Detection, because there are no ready data sets to leverage Machine Learning algorithms.
JBig Anomaly targets not only fraudulent activities but also ways to explore areas to help you with immediate financial gain, get more insight into product performance, increase your bargaining power with providers. Manage your claims teams and pre authorisation rules better by increasing automation levels even higher.
JRadar for Healthcare
Ever thought of a solution which can detect incompatible disease codes with services and operations provided to the patient.
With years of medical data gathering and accumulation our teams has develop JRadar for Healthcare which can detect abnormal and incompatible requests and immediately reject authorisations with automation.
JRenewal for Risk Management
One year already passed and the time has come for policy renewal. It looks like a batch process within core insurance suite however are you sure you should renew that policy ?
Did the client missed to report some past surgeries or existing illness. Well with millions of lines of patient request it's a though process to deliver manually.
We have developed JRenewal to look into patient records and automatically detect and misreported critical illnesses that has begun even before the policy was created.
Speciality medication for specific disease treatment,
Specific health services provided to cure criticall illnesses,
Doctor specialities like oncology
to further investigate patient records and recommend UW Exemptions, premium increase or cover limit reductions.