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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.

 

Analytics Blog

Electoral College put to the math test


With the campaign two months behind us and the inauguration of Donald Trump two days away, isn’t it time to put the 2016 U.S. presidential election to bed and focus on issues that have yet to be decided? Of course not.

Headlines

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U.S. Air Force and Disney receive the 2017 INFORMS Prize

The U.S. Air Force and The Walt Disney Company both received the 2017 INFORMS Prize for their pioneering and enduring integration of operations research (O.R.) and analytics programs into their organizations. The prizes were presented at the INFORMS Conference on Business Analytics & Operations Research in April in Las Vegas. Read more →

Air Force Academy’s O.R. program saluted

The U.S. Air Force Academy won the 2017 UPS George D. Smith Prize for its operations research (O.R.) program, which prepares graduates to become frontline O.R. practitioners as analysts in the Air Force. The program exposes more than 50 percent of cadets to at least one O.R. course and provides cadets the opportunity to graduate with a Bachelor of Science degree in O.R. Read more →

UPCOMING ANALYTICS EVENTS

INFORMS-SPONSORED EVENTS

CONFERENCES

2017 INFORMS Healthcare Conference
July 26-28, 2017, Rotterdam, the Netherlands

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