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 claim 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