The CO ASSESS Platform
On demand or dynamic fraud and waste assessment by combining multiple technologies and multiple data sources to maximize results accuracy, and to efficiently identify fraudulent claims.
Covariance has designed an advanced AI - based solution for health insurance fraud and waste detection. CO ASSESS is a great solution for screening any claim in order to identify possible fraudulent behaviors.
Dynamically linked to company’s database
User Friendly environment
Customizable to company's requirements
Reporting and KPIs
Are you intersted in CO ASSESS?
Contact us to discuss how your insurance business can benefit from CO ASSESS.
Contact usCO ASSESS Minimizes Cost & Expenses
CO ASSESS Platform assesses all claims, and flags possible fraudulent or wasteful ones, prior to reimbursement.
Administrative Cost Reduction
Operational Cost Reduction
Inspection Cost Minimization
Expenditure Control
Claims Prediction
Strategic Advantage in Pricing
Strategic Advantage in Underwriting
Ultra-High ROI
CO ASSESS Optimizes Claims Management & Claims Processing
CO ASSESS Platform combines multiple technologies, multiple data sources, and significant expertise of the leading team to maximize results accuracy, and to efficiently identify fraudulent claims. CO ASSESS Platform optimizes claims management and claims processing, trough introducing a paperless process.
Making claims settlement faster using an easy-to-use one-stop-shop
Safeguarding data safety since all processes are internal
Predicting future claims
Offering real time claims and fraud analytics
Optimizes claims management
Optimizes claims processing
Introduces a paperless process
Key Features
All your data connected in one place
Unified Visualizations
No code needed, easy application in just a few clicks
Scalable for vast amount of data
Dynamic Dashboards
Machine and Deep Learning Algorithms
Risk analysis reporting capabilities
Claims predictive analytics capabilities
AI-based Components
Fraudulent claims can be assessed and flagged, prior to reimbursement, using an advanced machine learning component that analyses available structured claim data."
Assess the healthcare expenditures invoiced by healthcare providers to insurance companies, in hospitalizations. Evaluates costs of services and frequencies of services invoiced by healthcare providers, compares charges for consumables to market prices, checks actual quantities compared to expected as defined by physicians and healthcare experts. A comparison of the invoiced prices with the market prices is made and an explanatory report is delivered.
The network analysis component combines ultra-modern technologies to enhance the insurance claims evaluation process. Using the claim information data, the network analysis component generates a possible fraud network map, including various parties (individuals and service providers) that may be involved in possible fraud or waste.
This component applies standard empirical rules to the data in order to flag possible fraudulent cases.
Fraudulent claims can be assessed massively and flagged, prior to reimbursement, using an advanced machine learning component that analyses available structured claim data.
This component applies dynamic comparative analysis in order to identify fraud cases based on the claim size data.
About COVARIANCE
Covariance is empowering leading healthcare organizations to deliver Data-Driven and AI solutions that shape the industry, while supports them to maximize their customers’ value and minimize risks & costs by integrating real-time analysis into existing systems and processes.
- Unique expertise in Artificial Intelligence in Healthcare.
- Strategic consulating in Healthcare business.
- Digital Transformation in Health & Insurance.
- Innovation in Genomics % Real World Data.
- Health Services Development % Improvement.