A new approach to automatically pinpoint suspicious billing activity.

Fraud, Waste & Abuse

DETECTION - PREVENTION - REPORTING

“Trust, But Verify!”

- Ronald Regan, 40th US President

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eAffirm’s multi-patented platform allows MCOs to effortlessly see real-time disparities and actionable insights that are visualized with interactive, customizable, sharable dashboards and reports to help identify and reduce Fraud Waste & Abuse (FWA) within their provider network.

We detect it

From simple over-coding to outright fraud and abuse, eAffirm’s suite of purpose-built FWA identification and investigation tools will give your teams unprecedented visibility into what’s really going on.

eAffirm’s multi-patented processes and interactive web-based platform, allow users to pinpoint suspicious behavior across all healthcare claim types, as well as custom applications. Our tools are designed to show users data insights that might have otherwise gone unnoticed or unconnected.

Better Data, Better recoveries!

We report it

With fully interactive dashboards, customizable reports & notifications, and full drill-down capabilities, we visualize FWA by order of magnitude and allow users to filter results the way they want, across a wealth of lead-inspiring categories and campaigns.

Our intuitive, easy-to-use interface and dashboards allow users to drill into leads visually or directly - by provider classification, speciality, code category, flag type, recommendation type, and numerous other lead inspiring categories, to help spot peer outliers and discover hidden insights..

All in real time.

We prevent it

Much like a home or business with an automated security system, thieves, greeds, cons, and the like are far less likely to perpetuate crimes or abuses against a network that is actively monitoring its members and billing activity.

With a Layer like eAffirm in place you create an exceedingly difficult environment for over-billing and surprise payments to exist, all while creating ZERO extra work for the provider or care staff. Passive can be Powerful.

Trust.. But Verify!

A Revolution in Detecting

Health Care Fraud, Waste, & Abuse

Visit Occurrence

Up Coding

DME Type & Delivery

Prescriptions Written

Patient Satisfaction

So Much More

Quality of Care

Services Rendered

After-hours Billing

Patient Identity

Length of Visit

Purpose Built Features:

Platform, Dashboards & Detail Reports

Your new nerve center - Fully interactive dashboards and never before available data sets combine with historical data and pattern recognition to create a F.W.A. Data visualization platform/layer purpose built and designed for increased oversight, increased investigations and increased recoveries. All in Real Time.

Better Insight, Better Recoveries.

Provider Risk-ReportCard™ & Disparity Score™

Comprehensive profile and report that allows you to compare providers to see outliers and disparities visualized by order of magnitude, in ways never before available. Every provider is different and our unique algorythmic approch lets you highlight their unique billing disparities in a uniform manner.

Better Data, Better Recoveries.

Evidence Tracker™

Understand why certain claims, providers, patients, members, service recipients, etc. are flagged with our detailed breakdown in plain English that provides SIU teams and sub-teams a transparent, point-by-point detailed accountability. Efficiently prepare for cases & audits with our Chain-of-Evidence™ protection.

Better Tools, Better Recoveries.

Fully Customizable SIU-Bot "Charlie"™

Scalable Automated Notification Solution that learns and builds over time. It's like putting our entire team of industry insiders and experts to work for you. We leverage the power of big data, machine learning, new data channels, and layers of proprietary algorithms into a scalable-on-demandsolution to Pinpoint Suspicious Billing Activity.

Better Reach, Better Recoveries.

Advanced Relationship Mapping

Tracks potential crimes and kickbacks perpetuated by networks of individuals working together. See groups of providers and how they interact all with the click of a button or the selection of a filter. Put safegaurds in place against out-of-network provider billing.

Pre-payment Manager

See approved and denied claims BEFORE your payments go out in a never before available, 360degree approached, multipatented layer of checks and verifications, that puts the power of analytics and live data together.. Giving you unprecedented access and oversight within your networks.

eAffirm’s Instant ID Verify™

Our Patented process combines the power of big data with eAffirm’s ID & Language Localization Engine "Eille" to allow for the verification of identity across a wide range of applications and environments, disrupting the ease of perpetuating medical identity, thefts and frauds.

Automated Appointment Reminders

Stop losing money and wasting care delivery time on missed appointments. Our system can reach out and confirm these instances then loop the data back into your system as well as our own proprietary suite of custom dashboards and tools, so you have everything all in one place.

eAffirm is:

HUB Certified

Fully HIPAA Compliant

Multi-Patented

Purpose Built Solution

"Out of box" Ready or Completely Customizable

Scalable on Demand

Multilingual Comprehension

Multi-Factor Authentication

Absolute Privacy First Policy

Automatically Personalized Smart Convos®

Peer-to-Peer Comparisons & Outliers

F.W.A. Severity & Frequency Ratings

Why us?

Fresh Thinking

A data based, connected approach to leverage big data with more than 50 million payer beneficiaries.

Expert Approved

Purpose built from the ground up with input from some of the best in the business.

Actionable Data

Fact-based allegations combined with objective & subjective modalities give you truly actionable insights.

Real-time results

Alerts, notifications, and recommendations. Customizable at any time on your campaign's settings page.

Unlimited Everything

Confirm as many services or transactions as needed. You are never billed for replies, audiences, or unresponsive recipients. We only meter for Results!

Privacy First

eAffirm is fully committed to complete and total privacy for all clients, the members in the network, and all end users of our platform and services. Privacy is Core.

Learn more keyboard_arrow_down

Simple To Use:

1

Upload or Connect your data and select data fields to import.
2

Select your customizable campaign settings or feel free to use ours.
3

Click Submit to launch your campaign & watch your insights take off.

We provide extensive services and support to help our customers implement and use eAffirm’s suite of fraud and risk management tools.

Working closely together, we’ll define the workflows and strategies to maximize recovery success and value-add, optimizing the way you manage risk and combat malicious efforts.

Contact us today to learn how to get started

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