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GEHA selects FICO Analytic Solution to intensify fight against insurance fraud, waste and abuse

Industry News

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.



Forbes names Dietrich a leader of the data analytics pack

INFORMS member Brenda L. Dietrich, an IBM Fellow, vice president and leader of IBM’s data science group, was recently profiled by Forbes in an article headlined, “Meet 9 Women Leading The Pack In Data Analytics.” Dietrich is also an INFORMS Fellow and a member of the National Academy of Engineering. She served as president of INFORMS in 2007. Read more →

Female board members more likely to have tech experience

Female members of corporate boards of directors are nearly twice as likely as their male counterparts to have professional technology experience, according to new research from Accenture. To understand the gender composition of corporate boards and the role technology plays in the careers of female board members, Accenture examined women’s representation on the boards of more than 500 Forbes Global 2000 companies in 39 countries across Europe, Asia, North America, South America and Australia. Read more →

Study: Consumers buy close to what they first searched online

Given the ease of online search, consumers can explore and discover hundreds of available items in any category. Retailers and advertisers are keen to influence the search and final purchase through better product recommendations and targeted advertising. A forthcoming article in the INFORMS journal Marketing Science studies online search and purchase behavior of consumers in the digital camera category and finds that even though consumers may search for extended periods of time, what they purchase tends to be remarkably close to items they searched and found in their very first search. Read more →



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Nov. 17-18, 2016, Nashville, Tenn. 


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