GSTEP helps AdvanceCare monitor fraud scenarios
The objective of the project developed is to analyse fraud and abuse scenarios using automated processes able to detect a large number of suspicious cases, as well as make the latter more readily available to internal areas, for analysis, and to institutional clients, through a user-friendly, fast-access Business Intelligence (BI) interface.
With more than 16 years of experience in the Healthcare Management area, AdvanceCare boasts extensive knowledge of Fraud and Abuse.
Nevertheless, the company felt the need to automate and systemise the monitoring of these issues, in order to be able to analyse a greater number of fraud scenarios.
Automated processes are capable of detecting a large number of suspicious cases, as well as making the latter more readily available to internal areas, for analysis, and to institutional clients, through a user-friendly, fast-access Business Intelligence (BI) interface. AdvanceCare resorted formerly to ad hoc processes (some of which, based on BI tools, are still used) and behavioural statistical analysis to detect deviations.
However, the need for manual operations and the long response times involved prevented the company from achieving the intended targets.
Therefore, it became urgent to implement an integrated, structured solution, able to integrate acquired know-how and speed up processes, in order to minimise the impact of deviations.
A long-time partner of AdvanceCare, GSTEP boasts a wide activity scope, which has added enormous value to our company. GSTEP’s in-depth knowledge of the technological resources used in this project was determining to its success, as their contribution allowed us to better meet our deadlines and general quality standards. We are extremely pleased with GSTEP’s work, as they possess vast knowledge of the product and have consistently and effectively met all our requests.