Payer organizations today have to guard against more than pre-pay and post-pay issues to protect themselves against fraud, waste and abuse. Malicious social media postings have become a constant threat in today’s healthcare environment. A more holistic method of protecting one’s assets and reputation that incorporates data analytics and secure cloud capabilities is needed if organizations are to stay ahead of the curve.
CGI’s end-to-end fraud, waste and abuse services incorporate Social Media Protection Services along with traditional pre-pay, post-pay and reimbursement solutions to identify, detect and scrub improper activities on social media sites across a wide array of venues—in real time—to provide customers with 360-degree, 24/7/365 protection.
Utilizing our holistic framework, CGI clients have seen savings rates in excess of 40 percent, far above the typical 20-25 percent. This has also led to an appeal uphold rate of greater 93 percent. The bottom line is that payers can count on this holistic approach to translate not into dollars and cents but also total peace of mind.