LexisNexis® Tackles Organized Crime within Health Care Fraud Through Social Network Analytics
November 9, 2011 — Bill Fox to Speak at the NHCAA Institute for Health Care Fraud Prevention 2011 Annual Training Conference
ATLANTA, – LexisNexis® Risk Solutions today announced that Bill Fox, senior director of health care, will speak at the National Health Care Anti-Fraud Association's Annual Training Conference. Mr. Fox's presentation will discuss how Social Network Analytics, a new advanced analytic tool, enables both commercial and government payers to combat the infiltration of organized crime rings as they relate to health care fraud.
Increasingly, law enforcement agencies and health insurers have witnessed the migration of criminals away from drug trafficking and more violent and heavily penalized areas of crime into the safer and more lucrative business of health care fraud. Much of the fraud activity that plagues health care is the result of organized, collusive activities among providers and between providers and consumers. Social Network Analytics bring visibility to these hidden relationships by leveraging a company’s internal data, public records data and derived and risk scored data sets to identify concealed relationships between people, assets, entities, property and medical providers to reveal collusion within a payer's network that might otherwise go unnoticed.
LexisNexis offers a comprehensive suite of health care solutions, including comprehensive identity management, data enrichment, and social and predictive analytics that help uncover fraud schemes and collusion throughout different points of the claims workflow.
In his presentation, Mr. Fox will focus on how Social Network Analytics:
- Provides insight into networks of businesses and individuals perpetrating health care fraud, going beyond mere linking or visualization
- Can be deployed to reveal and visualize hidden collusion, using real case studies
- Drives higher workflow ROI within government and commercial payers
2:30 p.m. Eastern Time, Wednesday, November 16
NHCAA Annual Training Conference
Hyatt Regency Atlanta
265 Peachtree Street NE
Atlanta, Georgia 30303
About LexisNexis Risk Solutions
LexisNexis Risk Solutions (www.lexisnexis.com/risk/) is a leader in providing essential information that helps customers across all industries and government predict, assess and manage risk. Combining cutting-edge technology, unique data and advanced scoring analytics, we provide products and services that address evolving client needs in the risk sector while upholding the highest standards of security and privacy. LexisNexis Risk Solutions is part of Reed Elsevier, a leading publisher and information provider that serves customers in more than 100 countries with more than 30,000 employees worldwide.
Our health care solutions assist payers, providers and integrators with ensuring appropriate access to health care data and programs, enhancing disease management contact ratios, improving operational processes, and proactively combating fraud, waste and abuse across the continuum.
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