Healthcare insurance companies face constraints in resources and time when identifying, qualifying, and accepting new leads for Fraud, Waste, and Abuse (FWA) cases, whether for pre-pay reviews or post-pay assessments. To address this challenge, HCFS has introduced FWA360LeadsTM as an automated solution within the workflow of healthcare plans, seamlessly integrated into HCFS’s FWA Precision EngineTM. This innovative tool utilizes AI models, including machine learning, to detect, present, review, and accept leads, optimizing the process and providing several business benefits:
