HCI Launches Anti-Fraud, Waste, and Abuse Medical Claims Solution

HealthCare Insight (HCI) unveiled Nucleus, a technology platform for fraud, waste, and abuse prevention and detection. Nucleus features advanced analytics , comprehensive risk scoring, and a customizable interface to help insurers stop fraud before medical claims are paid.

“Healthcare fraud could cost as much as $234 billion this year and is a huge contributor to the rising healthcare costs in America,” says Dr. Barry Johnson, president of HCI. “Nucleus is about giving healthcare payors what they didn’t think was possible. This application combines the best of current antifraud technology, including software as a service (SaaS), prospective detection, customizable dashboards, and predictive analytics. All of the features are packaged in an intuitive, user-friendly, visually enhanced interface that will greatly improve correct payment of medical claims for claims review departments, special investigation units, and medical directors everywhere.”