Big news! Qantev and Insurance Business Applications (IBA) are joining forces to bring plug-and-play AI to insurersLearn more

Qantev logo
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Fraud,
Waste & Abuse

Qantev helps clients detect complex over-billing and fraudulent patterns, at scale.

What
we offer

Qantev’s machine learning algorithms combine internal and external health claims data to pick up on patterns of unnecessary, mislabeled and fraudulent services.

Incoherent pricing

incoherent pricing

time or geographical discrepancy

time or geospatial
discrepancies

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unlikely treatment
frequency

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SUSPICIOUS
REFERRAL PATTERNS

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episode
incoherence

lack of test

lack of test
before surgery

How
We Do It

By identifying patterns of organised abuses, Qantev's advanced machine learning algorithms can isolate outliers to help trigger targeted audits.

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NEW SANITIZED
CLAIM

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UNUSUAL PATTERN
ANOMALIES DETECTED

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HIGHLIGHTS ABNORMAL
BEHAVIORS AND OUTLIERS

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TRIGGER TARGETED
AUDIT BY FWA TEAM

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