Insurance Fraud

 

Easily connect ALL your internal/external data

DataWalk is fraud analytics software which enables you to have a single interface where all of your data is visible, connected, and available for analysis. This includes data you may have from your claims system(s), CRM, and other internal sources, as well as data you can easily import and integrate from external subscription services, and data you can pull from other external sources such as Facebook, Twitter, and many more. DataWalk is based on a Big Data architecture which can easily handle many, many billions of records, so you don’t need to worry about running out of capacity even if you have vast amounts of data.
 
 

Proactively identify suspicious claims with greater accuracy

DataWalk is also fraud prevention software. DataWalk includes a simple interface for quickly generating sophisticated, intelligent claim scores which can be based on expert rules, machine learning, and/or DataWalk’s powerful social network analysis capabilities (such as automatic clustering). Being able to easily generate and tune these sophisticated scores can significantly reduce false positives in weeks, or even days. By coupling expert rules and DataWalk clustering, organized crime groups can be automatically identified. DataWalk is also a great platform for leveraging Machine Learning, as your Machine Learning models can be efficiently produced, deployed, and maintained, which enhances your capabilities for real-time risk scoring and alerting of suspicious claims.
 
 

Dramatically accelerate triage and analysis

With DataWalk fraud analytics software, you can accelerate claim triage by instantly seeing which components (Machine Learning, social network analysis, or expert rules) had the most influence on a high risk score, and then immediately – and/or automatically - assign that claim for further analysis or investigation. With more efficient triage comes the ability to review significantly more claims. DataWalk also dramatically accelerates investigations by giving you one single interface for an aggregated view of all your data, along with the ability to generate and support rules, scores, alerts, and maps all in one platform. DataWalk also includes a link chart facility which eliminates the overhead typically associated with preparing for link analysis, further accelerating results.
 
 

Automate and operationalize results

The DataWalk platform is designed to be a part of your Enterprise workflow. DataWalk has open APIs to import data from other systems, and to enable other systems to initiate DataWalk analyses or extract data or results from DataWalk. Suspicious claims can automatically be forwarded to SIU, without the need for manual intervention. DataWalk is very agile, even in a production environment, such that if you need to connect additional data sources, or create or change rules or scores, this can easily be done…and with little or no IT support. DataWalk includes basic case management functionality, or can interface with your existing case management system.
 
 

Vastly simplify data preparation

Unlike other fraud analytics software tools that require a massive data cleaning effort before you can even start to do analysis, DataWalk accepts your data as it is, and enables you to transform or massage the data as needed on your own, without requiring work from IT or data owners. DataWalk also provides you with an entity resolution capability, so that you can quickly identify whether multiple similar records may actually be associated with the same person or business.
 
 

Rapid deployment and fast ROI…with minimal IT support required

While other fraud analytics software systems can require months of deployment and data integration work, with DataWalk you can start generating results in just days. Once data access is enabled, the requirements for ongoing IT support are minimal. Customers often achieve tremendous ROI on their investment, with payback as fast as 30 days.
 

Demo: Health Insurance Fraud

Demo: Auto Insurance Fraud

Seeing Is Believing

 

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