Smarter detection starts with letting the data speak for itself. Unsupervised machine learning is becoming an increasingly valuable tool for detecting anomalies in complex healthcare datasets. As data continues to grow in both volume and complexity, traditional approaches to identifying unusual patterns are being challenged by the need for more scalable, adaptive solutions. One effective approach is the Isolation Forest algorithm,…
Technology & AI
Advancing Healthcare Claims Technology
IntegrityM partners with AI and machine learning developers to embed clinical, regulatory, and compliance expertise into the design and deployment of healthcare automation tools. As a trusted healthcare partner, we guide the use of AI/ML technologies in medical coding, claims analysis, and utilization review, transforming complex healthcare data into outcomes that are accurate, compliant, and defensible….
What Is Statistical Extrapolation and Why Does It Matter?
Extrapolation is a statistical method used to estimate values for an entire population based on a smaller, randomly selected sample. In healthcare audits, this technique allows auditors to review a manageable subset of claims and project the findings to the full universe, saving time and resources while maintaining statistical integrity when applied properly. This approach…
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We offer solutions as a trusted & reliable program integrity partner. With 30+ years of proven expertise, we deliver successful results for government agencies like CMS and the commercial sector. Explore how we can help.
Quality Data has to Lead the AI Charge
Author: Natasha Williams, Chief Operating Officer There is a wave of excitement in the industry surrounding artificial intelligence (AI), and not without reason. AI, with its ability to synthesize massive quantities of information at lightning speed, promises limitless possibility. I share in the collective optimism surrounding this new frontier. The detection and prevention of fraud,…
#TechTalk: “Why the “sprint” to Agile?”
Technology doesn’t have to be complicated. IntegrityM CTO Swathi Young’s #TechTalk series is designed to provide quick, digestible explanations of the latest trends in healthcare technology and innovation so that you can stay ahead of the game before you finish your morning coffee. The Agile Manifesto came into existence during the turn of the twenty-first…
#TechTalk: What is Artificial Intelligence, Anyway?
Technology doesn’t have to be complicated. IntegrityM CTO Swathi Young’s #TechTalk series is designed to provide quick, digestible explanations of the latest trends in healthcare technology and innovation so that you can stay ahead of the game before you finish your morning coffee. Artificial Intelligence, Machine Learning, Robotic Process Automation; these words have spread across…
IntegrityM’s C.O.D.A Named Winner of ACT-IAC Innovation Award
IntegrityM’s C.O.D.A. (COVID-19 Outreach Digital Assistant) was selected as a winner of a 2021 Innovation Award by ACT-IAC, a non-profit recognized as the premier public-private partner for the government tech community. C.O.D.A. is IntegrityM’s proprietary AI chatbot that harnesses powerful natural language processing (NLP) to streamline current public safety efforts that have arisen as a…
Integrity Management Services expands offerings to federal agencies through addition of BIC solutions to GSA Multiple Award Schedules
ALEXANDRIA, VA. — IntegrityM was recently awarded the addition of Information Technology SIN 54151S for IT Professional Services and SIN 54151HEAL for Health IT Services to our existing GSA Multiple Award Schedules (MAS). This award follows the company’s appointment of AI expert Swathi Young as its inaugural Chief Technology Officer to spearhead the company’s tech and…
IntegrityM CTO Swathi Young Selected as Finalist of STEM Leadership Award
ALEXANDRIA, VA: On January 28, 2021, Women in Technology (WIT) named IntegrityM Chief Technology Officer, Swathi Young as a finalist for the WIT Leadership Awards “STEM Leadership” category. This annual awards program “identifies, recognizes and celebrates female professionals who are leaders in the technology field and bring a unique vision and talent to the industry.”…
Signs of Fraud in Payment Arrangements!
Fraud in Medicare Advantage often operates under the radar, but relationships or subtle patterns can reveal its presence. To uphold program integrity, look beyond obvious data anomalies and consider these critical warning signs: Unusual referral patterns between providers/suppliers Frequent turnover of enrollment agents Unexpected spikes in plan-switching behavior At IntegrityM, we recognize that effective fraud…
Hidden Figures: Dealing with Bias in Artificial Intelligence
Artificial Intelligence (AI) applications are at our fingertips every day – think Siri, Alexa, Netflix recommendations, and spam filters. Most AI algorithms use large quantities of data to learn about human behavior (called machine learning). Machine learning is increasingly used in decision making – examples include criminal justice, credit/loans, recruitment, education, and clinical diagnosis. These automated…
