Special ArticlesUBC’s Sauder School of Business receives UPS Prize
INFORMS awarded its prestigious UPS George D. Smith Prize to the Centre for Operations Excellence at the University of British Columbia’s Sauder School of Business. The UPS George D. Smith Prize is awarded to an academic department or program for effective and innovative preparation of students seeking to be practitioners of operations research. It is accompanied by a $10,000 cash award.Read More
Special ArticlesIBM, partners seek to transform personal health with Watson Health Cloud
To dramatically advance the quality and effectiveness of personal healthcare, IBM is establishing a Watson Health Cloud that will provide a secure and open platform for physicians, researchers, insurers and companies focused on health and wellness solutions. The HIPAA-enabled Watson Health Cloud will enable secure access to individualized insights and a more complete picture of the many factors that can affect people’s health.Read More
Special ArticlesChevron wins INFORMS Prize for analytics excellence
The Institute for Operations Research and the Management Sciences (INFORMS), the leading association for analytics professionals, presented its 2015 INFORMS Prize for excellence in analytics and operations research to Chevron Corporation for its long and innovative history of applying analytics and operations research across the breadth of the worldwide energy company.Read More
GEHA selects FICO Analytic Solution to intensify fight against insurance fraud, waste and abuse
FICO, provider of analytics and decision management technology, announced that the Government Employees Health Association (GEHA) has upgraded to FICO® Insurance Fraud Manager and will be adding FICO® Blaze Advisor® business rules management systems to help it more broadly and effectively detect and prevent insurance fraud, waste and abuse (FWA).
GEHA is the second-largest national health plan and the second-largest national dental plan for federal employees, retirees and family members, serving more than one million covered lives worldwide. GEHA has been a long time user of FICO analytics to analyze medical claims and fight fraud prior to payment.
With the upgrade to FICO® Insurance Fraud Manager, GEHA can not only monitor medical claims but also can manage pharmacy and dental claims with fraud detection and prevention models, discovering new fraud schemes in additional areas. GEHA also will be using FICO® Blaze Advisor® business rules to proactively evaluate claims and stop known fraud earlier in the process, driving greater efficiency and results.
"Many organizations have adopted FICO's analytics-based solutions to address the enormously costly problem of health care fraud, waste and abuse," said Russ Schreiber, vice president and insurance practice leader at FICO.