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SPOT is a fraud knowledge base containing rules and alerts that also takes patterns of behavior and historical data into account.
Features
- Applies fraud rules to claims
- Examines ALL claims instead of just a sampling
- Provides descriptive reasons for why claims are flagged as suspicious
- Builds and monitors profiles of provider behavior
- Runs in batch
- Runs on multiple platforms without requiring code change
- Database independent
Benefits
- Flexible, rules-based structure provides quick implementation of new 'fraud alerts' and rule
- Descriptive reasons reduce time and effort by gathering and displaying all pertinent data in
one place at one time
- Object-Oriented approach provides quick development and ability to interface with existing
(legacy) systems
- Provides consistency in consideration of ALL claims
- Preserves your company guidelines
- Enables your company to meet all state-mandated regulations
Product Support
EDIWatch is 100% committed to your satisfaction with our products and services. A basic technical support package is included in our standard maintenance agreement. Additional contract options are available for consulting services and extended levels of product support.
For more information, please contact our sales office. |
(Systematic Profiling on Time)