The Most Effective Claims Analysis Available

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 company’s payment integrity strategy.

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Powered by the FWA Precision Engine™ 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 and robust rules knowledge base with advanced AI-driven anomaly detection to deliver the most effective claims data analysis available.

Maximize your ROI

Claims

%

Reduction in False Positives

in Savings for Just 1 Client

Why Organizations Choose HCFS

Whether youʼre struggling with spreadsheets or antiquated software, HCFS helps you 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, and Abuse 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 1,650+ industry rules knowledge base

AI driven anomaly detection alerts users to high-risk providers

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 FWA detection, prevention, analysis, medical record reviews, education, training, and more.

Our Services

SIU Services

HCFS’s experienced SIU team of industry experts help your workforce with the heavy lifting in FWA detection, prevention, analysis, medical record reviews, education, training, and more.

Our Services

Exceptional Customer Service

We have the best-in-class live customer support with consistent high satisfation rating from our clients. We provide regular webinars and educational materials with the latest advances in the industry.

Our Resource Center

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.

Our Resource Center

What Our Clients Say:

“Since using HCFS, weʼve seen an increase in our ROI thanks to greater identification of leads and an easy-to-use solution to track leads and cases.”

“HCFS has helped us in reducing the volume of false positives and giving us actionable leads to prevent fraud, waste, and abuse.”

“With HCFS we have improved ROI, better regulatory compliance, and accuracy of reporting to the states as result of data and activity tracking.”

“HCFS has provided greater team efficiency to process leads and cases, tremendous organization, very informative analytics and provider risk score to help prioritize alert...

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