Expert Snippets

In regulated industries such as healthcare, identifying errors is only part of the equation. The real question is this: what is the total financial impact across the full population? Statistical ...

Key Takeaways from NGMA AGT 2026: What Today’s Grants Landscape Means for Federal Agencies and Recipients

Kevin Gregory, Project Lead for a federal post...

Smarter detection starts with letting the data speak for itself. 

Unsupervised machine learning is becoming an increasingly valuable tool for detecting anomali...

AI and machine learning are increasingly central to fraud analytics in complex, highly regulated environments. As adoption accelerates, much of the public conversation focuses on algorithms, new architectures, improve...

In the ongoing effort to protect the Medicare program, deterrence stands out as a powerful and cost-effective strategy. While detection and enforcement remain critical, deterrence shifts the focus from reacting to fraud af...

Understanding the context of “Suspect Payments” 

In Medicare Advantage, payment practices work best when they are clear, consistent, and aligned wi...

Medicare loses an estimated $60 billion annually to fraud, waste, and abuse (FWA), a serious drain on critical health resources that directly affects the care and well-being of millions of beneficiaries. These losses not o...

We offer solutions as a trusted & reliable program integrity partner.

With 30+ years of proven expertise, we deliver successful results for government agencies like ...

News on an addiction treatment facility operator caught paying $2.9M in k...

Last week, the U.S. Department of Justice presented several cases highlighting how “the department’s investment in data analytics produces outsized returns” in its fight against healthcare fraud. Learn more about th...