Although efficiency can be improved with a system that reduces response time – which, in turn, reduces costs – one of the main problems faced by operators remains: fraud.
In order to reduce the impact on the process, Quidcare presents an anti-fraud solution – driven by artificial intelligence – that searches for, identifies, blocks and notifies organizations in case of abuses, as well as errors associated with the entire process.
This is a truly troubling challenge in the operation of Health Insurance Management organizations. According to the National Health Care Anti-Fraud Association of the United States,3% of the country’s health budget is spent on fraudulent schemes. In Brazil, reports indicate that for every 100 reais spent, 15 correspond to some type of fraud.