Cotiviti, a pioneer in data-driven healthcare solutions, will share insights on how organizations can use AI technologies to minimize healthcare fraud, waste, and violence (FWA) at the Ai4 2021 Healthcare Summit. In the panel discussion “Reducing Fraud, Waste, and Abuse with AI,” Cotiviti executive vice president of growth and innovation Nicole Neumarker will address how healthcare fraud costs the industry $100 billion or more per year and what organizations can do to combat this issue.
Neumarker will use her extensive experience in artificial intelligence and machine learning to demonstrate how a payer and provider organizations can use AI-driven technology to improve cost and efficiency while also addressing the industry’s long-standing waste and inefficiencies. She will also speak about Cotiviti’s extensive experience addressing healthcare waste with FWA clients. Neumarker will also highlight the company’s Caspian Clarity data platform’s role in assisting health plans and other stakeholders in identifying and eliminating unnecessary spending.
Caspian Clarity is one of the most comprehensive statistical databases in healthcare, containing data on roughly 60% of all U.S. healthcare transactions, and Cotiviti has been able to offer critical information to clients thanks to open access to this massive amount of data.
“Artificial intelligence is on the verge of revolutionizing how payers and providers detect deceptive and wasteful behavior,” Neumarker predicted. “Access to vast quantities of data, combined with AI-driven data analytics capabilities, is critical for health plans to flag unusual use and claiming trends for internal analysis and reduces the risk of emerging threats. If payers and providers will work together to address healthcare’s huge waste crisis, it can eventually be possible to devote significant resources to improving patient outcomes.”
Jon Hamdorf, chief operating officer of United Healthcare Community Plan of Kansas, UnitedHealth Group; Stephen Wong, John S. Dunn presidential distinguished chair and chief science informatics officer, Houston Methodist; and Pete Ellis, chief product officer at Red Box, will join Neumarker on the panel. The panel of healthcare executives will discuss how AI and machine learning will increase value and help solve the $100 billion+ waste issue in the industry.