SAS helps prevent European health fraud

Business analytics software provider, SAS, has partnered with the European Healthcare Fraud and Corruption Network to distribute information about how healthcare organisations can detect and prevent healthcare fraud.

Belgium based EHFCM, which helps its members deter, detect, and address healthcare fraud by providing information, tools and best practice, will collaborate with the company to promote SAS’s Fraud Framework for Healthcare to healthcare organisations and insurers.

Julie Malida, principal for healthcare fraud for SAS, said: “Healthcare fraud is a worldwide issue, and awareness is rising among the general public and inside organised crime rings.

“The money lost to fraud and corruption in healthcare are 100 times more than those in the credit card industry, yet the investment in fighting health care fraud is far less.

"Sophisticated fraudsters and criminal rings realise this and have moved fully into health care fraud across country borders now.”

The SAS Fraud Framework for Health Care provides advanced analytics that enables organisations to make predictive, accurate claims decisions before claims are paid.

It includes components that detect suspicious activity, provide alerts for monitoring systems and provides risk calculations scores. It also includes case management tools that allow organisations to store information regarding fraudulent activity.

Paul Vincke, president of EHFCN, said: “According to a report issued earlier this year by McIntyre Hudson and EHFCN, healthcare organisations, regardless of specialty, lose 5.59% of the money spent on healthcare to fraud and error.

“Europe cannot afford to lose more money to healthcare fraud and corruption. We need to prevent the corrupt minority from engaging in fraud and abuse, and we need to mobilise the vast majority of honest people.

"SAS’ leadership in the global health care industry and its unparalleled technology framework will help EHFCN further that cause throughout Europe.”

Links: SAS

European Healthcare Fraud and Corruption Network