By working with Concord Europe’s AI Cloud platform, our client developed an analytics application that analyzed internal and external data to flag and evaluate malicious activities by in-network providers.
The approach collected external, publicly available unstructured data augmented with governmental and internal enterprise data to apply an array of NLP, ML, and deterministic approaches in a continuous manner.
After a month of operating under the newly created system, our client:
- Identified 612 questionable providers potentially involved in fraudulent activities
- Saved $2.3B USD in damages against the national and private insurance funds
- Cleaned up 500+ malicious providers from the network
- Improved providers’ data reliability by 250%