Qantev Partners with Pacific Cross to Deploy AI-Powered Claims and Fraud Solutions Across Five Countries in APAC – Learn more
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
Time or geospatial discrepancies
Unlikely treatment frequency
Suspicious referral patterns
Episode incoherence
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.
New sanitized claim
Unusual pattern anomalies detected
Highlights abnormal behaviors and outliers
Trigger targeted audit by FWA team
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