Gartner recommends Payers “invest in PPI solutions that detect and prevent improper payments in addition to those that perform retrospective claims payment analysis.”
Healthcare Fraud Shield is a one stop shop providing healthcare companies the tools they need to through both Prepayment and Postpayment and a combination of Artificial Intelligence, Advanced Analytics, Targeted Analytics and Shared Analytics across multi-payer data to:
- Prevent Fraud, Waste, Abuse and Error
- Reduce Costs
- Improve Claim Review Efficiency
Healthcare Fraud Shield was founded in 2011 to offer innovative fraud, waste, and abuse (FWA) solutions to the healthcare insurance industry. FWAShield™ was developed by industry leading healthcare subject matter experts with the latest technology available today to provide the most affordable, flexible, transparent, efficient, and effective solution in the marketplace. The focus of Healthcare Fraud Shield is solely on healthcare fraud prevention and payment integrity with a successful approach based on many unique advantages we deliver to our clients. Healthcare Fraud Shield’s fraud, waste, and abuse software as a service platform – FWAShield™ – is an integrated solution consisting of PreShield™ (pre-payment), AIShield™ (AI), PostShield™ (post-payment), RxShield™ (pharmacy analytics), QueryShield (ad hoc query and reporting tool) and CaseShield™ (case management). Our newest initiative, PostShield Shared Analytics leverages the knowledge of multiple payer data to identify emerging FWA.
Gartner Clients can access the 2022 Gartner Hype Cycle for Prospective Payment Integrity Solutions here:
https://www.gartner.com/interactive/hc/4016586?ref=solrResearch&refval=334129034
Gartner, Gartner Hype Cycle for U.S. Healthcare Payers, 2022, Mandi Bishop, Connie Salgy, 15 July, 2022
GARTNER DISCLAIMERS:
GARTNER and HYPE CYCLE are the registered trademarks of Gartner Inc., and/or its affiliates in the U.S. and/or internationally and have been used herein with permission. All rights reserved. Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner’s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.