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Managed Care March 2006 John Carroll	New Tools to Detect Fraud Rely on Discovering Patterns The ability of the computer to find unexpected - and often unwelcome - patterns of utilization for health insurance is at the heart of today's fraud detection methods.
Insurance & Technology June 1, 2006 Maria Woehr	Uncovering Crooked Claims Finding fraudulent claims can be challenging. But with the use of rules-based analysis, data mining and predictive modeling, insurers are waging a war on scam artists.
Insurance & Technology December 21, 2009 Nathan Conz	Insurers Leverage Data Mining and Predictive Analytics to Mitigate Increasingly Complex Fraud Schemes In the area of fraud mitigation technology, insurers are employing data mining and predictive analytics technologies in increasingly innovative ways to identify obscured data patterns and establish effective benchmarks for claims investigations.
Insurance & Technology April 8, 2008 Nathan Conz	Medical Mutual of Ohio Seeks to Discourage Fraud Before It Occurs Medical Mutual of Ohio leverages ViPS' Star Sentinel software to better identify potentially fraudulent claims activity and discourage fraud before it begins.
Commercial Investment Real Estate Sep/Oct 2009 Andrew Dick	Understanding Federal Healthcare Laws Commercial real estate professionals who work with medical office development must be aware of the federal healthcare fraud and abuse laws.
BusinessWeek January 6, 2011 Justin Blum	Why Medicare Can't Catch the Fraudsters One provider's claims were paid despite unusual billing patterns
Insurance & Technology August 16, 2010 Amelia Harnish	Analytics Improving Insurers' Claims Fraud Detection Efforts Fighting claims fraud still requires legwork, but anti-fraud technologies such as analytics are streamlining and improving the investigation process.
Bank Technology News June 2001 Karen Epper Hoffman	Vendors Take Aim at Online Crooks Neural nets help combat payment fraud...
Managed Care April 2001 Gregory J. Borca	Technology Curtails Health Care Fraud The amount of fraud in the health care system is staggering, but computer analysis can help reduce the level. Here is one company's strategy...
New Architect May 2002 Jesus Mena	Active Fraud Prevention Using data mining to combat online theft...
Fast Company November 19, 2011 Tristram Korten	Cracking Down On $70 Billion Worth Of Medicare Fraud A pharmacy run out of this storefront near Miami billed a federal agency for $776,298 - in just nine days. There were no real employees. There were no real patients. There were no real prescriptions. How medical fraud has become an untreated epidemic.
Insurance & Technology August 13, 2008 Peggy Kendler	Emerging Technologies Fight Claims Fraud Industry insiders discuss predictive modeling and other tools allowing special investigations units (SIUs) to be more proactive in their fight against claims fraud.
Bank Systems & Technology May 5, 2007 Maria Bruno-Britz	Fraud Techniques Evolve in Parallel with Bank Products and Defenses As fraudsters' techniques evolve alongside the products and services offered by financial institutions, new steps must be introduced to stop them.
Commercial Investment Real Estate Sep/Oct 2009 Andrew Dick	Deal Diagnosis Healthcare real estate transactions not only are driven by economic factors, but also by compliance with federal and state healthcare laws.
Insurance & Technology September 6, 2007 Nathan Conz	Data Mining Improves Fraud Mitigation Efforts Data mining can help insurers access and leverage the institutional knowledge vital to fraud mitigation efforts that is locked inside their current and historical claims data.
Insurance & Technology August 13, 2008 Ellen Melchionni	Analytics Key to Proactive Detection and Prevention of Fraud Advancements in technology have made it so that fighting fraud is no longer as closely linked to searching for the proverbial needle in the haystack
Managed Care October 2002 Frank Diamond	Prevent Crime From Paying: Fight Managed Care Fraud Despite popular belief, managed care is not fraud-proof. Every $1 that health plans spend to set up special investigation units could result in $7 recovered.
Insurance & Technology September 16, 2005	Techwatch Online Benefits launches a benefits administration tool... Fair Isaac released Payment Optimizer 2.5... Lumigent Vulnerability Manager DB 3.0... Unitech Payments Processing Solution... etc.
Insurance & Technology August 7, 2008 Stuart Rose	Insurers' Fraud Technology Is Behind the Times But network link analysis, voice stress-recognition software and other emerging analytics technologies, along with fraud propensity scoring, can bring carriers up to speed.
BusinessWeek July 11, 2005 Berner & Carter	Swiping Back At Credit-Card Fraud Bogus transactions are falling overall, but e-tailers are still feeling the pain. E-tail credit-card fraud is triple the rate of the brick-and-mortar world.
Bank Systems & Technology August 2, 2005 Phil Britt	Fighting the New Face of Fraud Technology plays a critical role in banking fraud, both in creating new opportunities for fraud and offering new methods to defend against it. Financial services institutions must take a holistic approach to combating fraud.
BusinessWeek November 12, 2009 Catherine Arnst	10 Ways to Cut Health-Care Costs Right Now Employers and hospitals don't have to wait for Congress to address inefficiencies and waste.
Bank Technology News May 2007 John Adams	Healthcare: Fifth Third Wants a Healthy Future Banks are well positioned to be the nexus between payers, providers and patients. But to automate medical payment documents banks must cope with a new level of complexity.
Insurance & Technology March 18, 2005 Anthony O'Donnell	Man and Machine Insurers generally tout the human factor as the most decisive element in successfully combating fraud, and Medical Mutual of Ohio is no different. They also credit technology as a key player in preventing fraud.
Bank Systems & Technology August 27, 2009 Maria Bruno-Britz	Evolving Fraud Schemes Keep Pressure on Evolving Payments Instruments While some of the latest schemes borrow from scams past, today's fraud schemes are as sophisticated as banks' most advanced payments systems. And stopping them is still a challenge.
Bank Systems & Technology August 2, 2005 Phil Britt	Keeping Up With Fraudsters As fraud schemes become more sophisticated, banks need to examine a wider array of data to identify fraud trends. That means investing in more sophisticated technology systems, adding personnel and employing additional fraud-fighting processes.
Bank Systems & Technology February 22, 2007 Maria Bruno-Britz	JPMorgan Chase Acquires Assets of Healthcare Remittance Provider Purchase of FisaCure will enable JPMorgan Chase to offer a broader array of services to the healthcare industry and encourage adoption of electronic payments.
Insurance & Technology September 6, 2007 Nathan Conz	Potentially Fraudulent Insurance Claims Must Be Identified Early Experts agree that identifying fraud indicators early in the process is a key to successfully resolving cases.
Bank Technology News January 2010 John Adams	Thank Payments Innovation a Bundle Like a specialist working with a primary care doctor, US Bank takes a tag-team approach to bundling commercial lending with payments and processing automation.
InternetNews March 31, 2009 Kenneth Corbin	Internet Crime Complaints Soared 33% in 2008 Driven by problems with e-commerce transactions and fraud, complaints skyrocketed last year.
Inc. September 18, 2002 Carole Matthews	Preventing Small-Business Fraud Small businesses are more likely to become the victims of fraud than larger businesses. Here's how you can prevent fraudulent activity in your workplace.
Bank Systems & Technology August 24, 2006 Nancy Feig	BITS Releases Insider Fraud Database BITS, a nonprofit consortium of 100 of the largest U.S. financial institutions, released its own insider fraud prevention service, which consists of a list of former financial institution employees who have compromised consumer information and/or knowingly caused financial losses.
Pharmaceutical Executive May 1, 2005 Robert Ullmann	Back Page: Unhealthy Justice More than any other healthcare law, the Medicare/Medicaid exclusion statute has distorted our criminal justice system with government fraud investigations. This well-intentioned but misguided law should be repealed.
Insurance & Technology August 13, 2008 Dennis Jay	Predictive Analysis Allows Insurers to Stay Ahead of Constantly Evolving Fraudsters When used with data mining tools and street investigations, predictive analytics can be among the biggest electronic enemies of the fraud rings that cost insurers tens of billions of dollars annually.
Bank Systems & Technology December 1, 2003 Jim Middlemiss	Fifth Third Stays Seven 'Steps' Ahead of Fraud Bank implements seven new fraud-detection systems to fight check and ID fraud.
Insurance & Technology August 7, 2008 Tom Brennan	Fraud Detection and Prevention Starts With Good Data Neural nets, predictive modeling, and other analytic technologies allow insurers to address potential issues proactively.
InternetNews November 15, 2004 Sean Michael Kerner	Online Shopping Season a Target For Fraud Monday may be the most popular day to shop online this holiday season but fraudsters don't care what day of the week it is.
Managed Care October 2003 John L. Phelan	Pay Incentives to Physicians For Filing Electronic Claims Physicians' well-known reluctance to invest in office computer hardware and software is costing health plans money. How to get the docs' attention?
Bank Technology News September 2010 Tom Leuchtner	Patrolling the Neighborhood Cyber criminals are employing increasingly sophisticated methods to perpetrate financial crimes.
The Motley Fool February 24, 2009 Brian Orelli	Health Insurers Hammered. Again. Health insurers were blown away by the Centers for Medicare and Medicaid Services' announcement that it plans to raise the 2010 Medicare Advantage payment rates by only 0.5%.
InternetNews May 22, 2007 David Needle	Report: Click Fraud on Sophisticated Rise Fair Isaac's preliminary results, disputed by Google, indicates click fraud in pay-per-click advertising may be as high as 15 percent.
CRM December 27, 2013 Griffin & Galat	When Fraud Prevention Gets in the Way of Customer Experience Online merchants must balance protecting customers with giving them what they want.
Bank Systems & Technology November 26, 2007 Nancy Feig	SAS Builds Card Fraud Protection With HSBC To fight credit and debit card fraud, HSBC has developed a new real-time detection solution with SAS.
Insurance & Technology August 2, 2010 Nathan Golia	PHRs Gain Popularity Among Insurers Health insurers are looking to consumer-directed online personal health records as a way to encourage members and providers to share updated healthcare information.
Chemistry World May 19, 2011 Leila Sattary	Phony research projects swindle EC out of millions Italian authorities have exposed a vast web of phony science research projects that stole more than 50 million from the European Commission.
Bank Technology News December 2007	Enterprise Fraud Management: HSBC Boosts Bottom Line with Anti-Fraud Tool Given the credit-market turmoil of late, tightening risk controls and deploying better risk analytics firmwide can only be a good thing for financial institutions.
BusinessWeek October 1, 2009 Sasseen & Arnst	Why Business Fears the Public Option Executives contend that it will lead health-care providers to charge patients in private plans higher rates.
The Motley Fool May 29, 2009 Brian Orelli	The "Naughty List" You Want Your Company On Athenahealth is out with its annual review of how quickly health insurers are paying the claims that doctors make for services.
Bank Technology News December 2009 John Adams	Post Oak Performs a Paper-ectomy While responsibility for insuring healthcare payments has been mired in political debate that's touched all points on the national intellect curve, the virtue of automating those payments should be of little doubt.
Managed Care December 2006	NCQA Rankings Give Edge to Not-For-Profit Insurers No sooner had the quality rankings of health plans in the nation, as measured by the National Committee for Quality Assurance, been released then it was pointed out that most of the top performers were not-for-profit insurers.