Protect Every Dollar.
Strengthen Every Claim.
Healthcare Fraud Shield offers an end-to-end, enterprise-wide solution for payers, encompassing Payment Integrity, Cost Containment, Compliance, SIU, Credentialing, Pharmacy and more.
Enhance Your Payment Integrity Efforts
For clients already utilizing Healthcare Fraud Shield’s services, additional tools are available at no extra cost:
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Integrated Tools for Effective Payment Integrity
FWAE Detection & Prevention
Identify and prevent fraud, waste, abuse, and errors.
Pre-payment & Post-payment Analysis
Evaluate claims before and after payment to ensure accuracy.
Auditing
Conduct thorough audits to validate claim legitimacy.
Auto-decision Claims
Automate claim decisions to improve efficiency.
Medical Record Retrieval
Access necessary medical records seamlessly.
Provider Screening & Profiling
Assess and monitor provider credentials and behaviors.
The strongest defense for your healthcare dollars.
Why Our Approach to Payment Integrity Works
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Integrated technology + expert oversight |
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Rule-based and AI-driven analytics |
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Custom workflows for your plan |
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Proven ROI across clients of all sizes |
