An AI venture is dedicated to combating fraud in the healthcare and life sciences sectors, addressing the staggering $68 billion lost annually to Medicare and Medicaid fraud. The complexity of medical records makes it difficult to swiftly identify fraudulent activities, prompting the need for enhanced detection capabilities.
The Challenge
- Vast amounts of complex medical data complicate the identification of fraudulent activities in billing.
- Existing systems struggle to process the volume and intricacies of fraud detection effectively.
- Quick and accurate uncovering of fraudulent patterns is hindered by outdated methodologies.
- There is a critical need for improved tools to analyze and detect fraud in real time.
THE Solution
- Developed a comprehensive solution utilizing advanced AI methodologies and graph capabilities.
- Processed over 5 billion data points to assess fraud probability through similarity calculations.
- Implemented big data ingestion, handling over 3,000 records per second for efficient processing.
- Employed machine learning techniques with graph databases to identify collusion rings indicative of fraud.
Increase in Data Ingestion Speed
Row Records Processed
Edges/Links Within Graph Database
Technologies
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Proof of Concept Development
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Artificial Intelligence
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Graph Modeling
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Statistical Analysis
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Machine Learning
"Our team harnessed advanced AI to revolutionize fraud detection, transforming the way healthcare data is processed and analyzed for faster and more precise results."
- Dr. Yaqi Chen, Lead Data Scientist
Consulting & Strategy
Outcome-focused, real-world practicality combined with courageous innovation
Technology & Transformation
Expert engineering from project initiation to deployment and beyond
Technical Leadership & Support
Empowerment to scale your solutions long after our engagement has ended
