Real-Time AI Powered Health Insurance Fraud Detection and Prevention

Protect your organization instantly with ToolCASE, the world’s most advanced transactional AI fraud detection platform. Powered by AI and real-time analytics, ToolCASE’s powerful suite of AI tools is proven to detect, reduce and prevent health insurance fraud; allowing your organization to retain and grow revenue – potentially saving tens of millions of dollars in fraudulent claims.

With over 25 years of big data expertise, ToolCASE’s RembrandtAI anti-fraud systems will give your healthcare insurance organization the proven ability to:

• Detect healthcare provider fraud
• Identify upcoding and overbilling
• Stop phantom billing and phantom patients
• Prevent fraudulent claims
• Identify fraud in real-time
• Measure risk in real-time
• Measure & Identify these risks across all data channels
• Visualize and pinpoint potential risks via a real-time dashboard
• Save tens of millions of dollars in fraudulent claims

Preventing Fraud At Your Health Insurance Organization Starts with ToolCASE

Our advanced Artificial Intelligence solutions detect, in real-time, fraudulent claims from patients, providers and every point in the healthcare chain. We can identify upcoding and overbilling, preventing CPT code fraud – and much more – by identifying and pinpointing risk, minute irregularities and anomalies before costly payouts are made.

ToolCASE knows the complexities and sophistication of health insurance fraud.

From patients, payers, physicians, employees, vendors, suppliers and pharmacists, our RembrandtAI and machine learning engines can examine millions of live actions and transactions, separating legitimate behavior from fraudulent behavior as it’s happening.

With our depth of domain expertise in institution fraud, we are the early warning radar that will help you save potentially tens of millions of dollars in fraudulent billing.

To learn more about real-time fraud detection, and experience a demonstration of our advanced capabilities, simply submit your organizational contact information and a ToolCASE representative will get right back with you.