The Black Hole of Healthcare Spending
There are staggering statistics about the current US national debt and the percentage attributed to healthcare programs like Medicare and Medicaid.
There are well-documented problems of fraud, waste, and abuse: upcoding, phantom billing, medically unnecessary procedures …
Traditional human-led audits are slow, expensive, and only catch a tiny fraction of the problem, creating a massive accountability gap.
Enter the AI Auditor, A New Paradigm for Transparency
Using advanced AI and machine learning models to analyze massive healthcare claims datasets in real-time.
AI can identify complex patterns of fraud that are invisible to human auditors: collusive networks of providers, subtle anomalies across millions of claims …
The current model is “pay and chase” … what about a future of “pre-payment verification” where AI flags suspicious claims before a single taxpayer dollar is spent?
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