White paper

Staying one step ahead of fraud, waste and abuse

Stay ahead of healthcare fraud with advanced AI technologies

Healthcare FWA Report Cover Image

Health plans are overwhelmed by fraudulent activity. Unfortunately, the pandemic opened the door for even more cybercriminals to find new schemes to submit improper, fraudulent claims.

Given the sheer volume, it’s impossible to pursue every instance of healthcare fraud. Health plans have launched special investigation units with high-dollar cases as their top priority. While many lower-value cases fall by the wayside, these cases can have a broad impact on patients, quality of care and financial results.

A new white paper, a collaboration between Mastercard Healthcare Solutions and Becker’s Hospital Review, looks at the fraud landscape, drawbacks of current approaches to fight fraud and the role of AI in preventing fraud.

This white paper details:

  • The magnitude of fraud in healthcare
  • Drawbacks of the rules-based approach used by many organizations
  • Why leading healthcare organizations are turning to AI for data protection and fraud prevention
  • Specific solutions that can reduce fraud, waste and abuse

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