Catch a fraudster: Finding the needle in the haystack with AI

The precise figure is unknowable because only 3 to 10% of this fraud is ever detected. With more data in health care than ever before, what is the opportunity to use artificial intelligence (AI) and other advanced analytics techniques to improve fraud detection? That was the topic of a recent webinar featuring Prime Therapeutics, the pharmacy benefit manager that Fast Company named among the world's most innovative companies for 2020 for their use of SAS Detection and Investigation for Health Care to fight fraud, waste and abuse. SAS Medical Director Steve Kearney, PharmD, hosted the webinar. Prime Therapeutics integrates pharmacy and medical claims into an advanced analytic engine to identify cases for their investigators.