Partner Spotlight: Pondera, a part of Thomson Reuters

Healthcare fraud costs the nation as much as $300 Billion annually.  Thomson Reuters provides a healthcare fraud, waste, and abuse platform that leverages risk scoring and data analytics within your historical claims data.  With our added analytics and numerous proprietary and public data sets, your team can immediately understand which providers are working appropriately within the system and which might need education and remediation.  Your teams will receive a holistic, prioritized view into your entire population’s claim stack.  Combining your data with identity verification and deep human analytical review provides an unmatched ability to detect, prevent, and investigate fraud within your program.

To further understand ongoing waste and abuse risk in your program, our Fraudcaster solution ingests your historical program data, matches it against pre-integrated third-party data sources, and then runs it through a series of procedural and prediction models to detect previously known and unknown anomalies and patterns.  Prior to running client data through Fraudcaster, a source data validation process ingests program data and checks its data integrity, usability, stability, and fitness for analytics ensuring you can trust the results displayed during your analysis.

From this dashboard, your team can easily create cases and transfer the relevant data to the CaseTracker platform, an integrated fraud, waste, and abuse tracking system.  With CaseTracker, you can perform multiple functions, including referral assessment, case development, prosecution/hearing referral outcome tracking, and utilization of investigative outcome data to identify trends and best practices.  CaseTracker includes the features and functions required to maximize successful case outcomes for your agency, while preventing fraud.  For more information visit: https://www.ponderasolutions.com/