The Most Effective Claims Analysis Available
Industry-leading healthcare insurance companies rely on the HCFS Platform™ for Payment Integrity, Cost Containment, and Fraud, Waste, Abuse and Error (FWAE) to deliver millions of dollars in savings, recoveries, and prevented loss each year — a critical component of your company’s cost savings strategy.
Powered by the FWA Precision Engine™ PI and SIU teams can investigate pre-payment and post-payment fraud, waste, abuse, and error claims quickly and with confidence.
The HCFS Platform™ powered by the FWA Precision Engine™ combines a proprietary data fusion library, robust rules knowledgebase, and advanced AI-driven anomaly detection complete with an end-to-end solution for auditing, SVRS, medical record retrieval and more to deliver the most effective solution available.
Claims
%
Reduction in False Positives
in Savings for Just 1 Client
Why Organizations Choose HCFS
Whether you are struggling with spreadsheets or antiquated software, HCFS offers and end-to-end solution that helps your payment integrity, cost containment, and SIU departments reduce false positives and improve claim payment accuracy — saving significant time and money.
Actionable Insights
Leading FWA Subject Matter Experts
Superior Customer Service
Only the HCFS Platform™ is powered by the FWA Precision Engine™
Industry-leading healthcare insurance companies rely on the HCFS Platform™ for Fraud, Waste, Abuse, and Error to deliver millions of dollars in savings, recoveries, and prevented loss each year – a critical component of your companyʼs payment integrity strategy.
Data fusion library aggregates internal and external data sources like NPI, SOS data, state sanction lists, and virtual offices.
Proprietary shared analytics database sources data from 70MM+ payers nationwide.
Robust and expanding 1,900+ industry rules knowledge base.
AI driven anomaly detection and alerts users to high-risk providers, claims and members.
Drill down to claim-line level detail.
Fully integrated modules including pre- and post-payment data
SIU Services
HCFS’s experienced SIU team of industry experts help your workforce with the heavy lifting in FWAE detection, prevention, analysis, medical record reviews, education, training, and more.
Exceptional Customer Service
We’re your go-to data source for healthcare fraud, waste, and abuse trends, providing regular webinars and educational materials updated with the latest advances in the industry.
What Our Clients Say:
Stay up to date on the latest in healthcare fraud, waste,
abuse, and error.
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