The medical injuries benefits system faces a percentage of waste, abuse, and claims, in some cases potentially fraudulent, that may be left unrecovered. When not addressed, this could undermine profits, enable bad actors, and increase costs for the organization. Payers need a scalable solution and proactive identification to support the magnitude of improper payments.
CGI Precision quickly identifies and prevents waste and abuse occurrences for health, property, casualty, and workers' compensation insurers. CGI Precision brings together payment integrity, advanced analytics and artificial intelligence (AI); waste and abuse data; and a community of contributing members for more precise analysis and action. CGI Precision takes identification to the next level by providing operational intelligence and alerting for improved operations decision-making. CGI has the history, insight, and capability to impact an insurer's claims costs, underwriting effectiveness, and reserves with this new-to-market comprehensive solution.
- Strong program results with savings found in 60 percent of claims audited
- CGI has recovered over $3B in improperly paid claims
- Our approach has set the standard with an industry-leading 96 percent appeal uphold rate
- With more than 30 years of experience in Medicare, Medicaid, and commercial plans, CGI knows what our clients value
- Comprehensive logic and business rules leveraging AI, machine learning, and algorithms
- Geospatial and geo-temporal (location and time) analytic insights for operating intelligence and alerting