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Description
Benford's law serves as a tool for uncovering patterns indicative of improper disbursements. It involves examining audit trail reports from QuickBooks or other bookkeeping software to pinpoint unusual activities like voids and deletions. Additionally, it entails identifying multiple payments made for identical amounts on the same day. A thorough review of payroll runs is conducted to detect any payments exceeding the established salary or hourly rates. Payments made on non-business days are also scrutinized. Statistical calculations help in identifying outliers that may suggest fraudulent activity, and duplicate payments are tested for validation. Vendor files in accounts payable are analyzed for names that may be suspiciously similar, and investigations are conducted to uncover fictitious vendors. Comparisons of vendor and payroll addresses are evaluated using Z-Scores and relative size factor tests. While data monitoring and surprise audits have shown to significantly reduce fraud losses, only 37% of organizations implement these critical controls. For businesses employing fewer than 100 individuals, the average loss due to fraud is estimated at $200,000, highlighting that smaller enterprises often lack the necessary resources to effectively detect and address fraudulent activities. Consequently, it is essential for small businesses to adopt more robust fraud detection mechanisms to safeguard their financial integrity.
Description
Uncover the concealed links and associations between claimants, providers, and businesses to assist in detecting systemic insurance fraud. The sophisticated analytics offered by NetMap significantly bolster the SIU's capacity to uncover fraud networks within their organization's claims. This software rapidly assesses claim data, public documents, and additional information to highlight patterns that suggest fraudulent behavior. With robust analytics and data visualization tools, SIU analysts can swiftly identify complex patterns of deceitful activities. By condensing weeks of investigative work into just a few hours, NetMap not only enhances the efficiency of organized claims fraud probes but also accelerates the process from detection to referral, ensuring a more effective approach to combating fraud. Moreover, the application of these tools can lead to more informed decision-making and improved overall outcomes for the insurance industry.
API Access
Has API
API Access
Has API
Integrations
No details available.
Integrations
No details available.
Pricing Details
$1,400 one-time payment
Free Trial
Free Version
Pricing Details
No price information available.
Free Trial
Free Version
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Vendor Details
Company Name
MedCXO
Country
United States
Website
medcxo.com/fraud/
Vendor Details
Company Name
Verisk Analytics
Founded
1971
Country
United States
Website
www.verisk.com/insurance/products/netmap-analytics/
Product Features
Fraud Detection
Access Security Management
Check Fraud Monitoring
Custom Fraud Parameters
For Banking
For Crypto
For Insurance Industry
For eCommerce
Internal Fraud Monitoring
Investigator Notes
Pattern Recognition
Transaction Approval
Product Features
Fraud Detection
Access Security Management
Check Fraud Monitoring
Custom Fraud Parameters
For Banking
For Crypto
For Insurance Industry
For eCommerce
Internal Fraud Monitoring
Investigator Notes
Pattern Recognition
Transaction Approval