Fraud Detection and Management

Claims & Adjudication

Fraud Detection and Management

Insurance benefits should be properly adjudicated for every claim. This means insurance companies need to fully analyze claims and their proper value based on all the available data. Given that there’s a lot of data involved, correct adjudication requires solid processes and checks to ensure that no false or fraudulent claims are approved for payment.

ADEC Innovations Health Solutions has both the analytical tools and the human expertise to enhance your organization’s fraud detection capabilities. Our effective use of analytics and statistical tools and methods, as well as efficiency in managing claims and reducing payments for fraudulent claims, helps insurers increase their profitability.