UPIC Data Analysis Services

Considering the amount of Medicare and Medicaid fraud perpetrated every day, it is a safe assumption that evidence of fraud, waste, and abuse can be found whenever large Medicare or Medicaid data-sets are analyzed. Hints, clues, and patterns are there for a skilled data analyst to discover.

IntegrityM has years of experience providing data analysis and has successfully identified vulnerabilities for both government agencies and private sector government support contractors. Our UPIC data analysis services help our clients identify waste and fraud and develop effective plans of action.

To discuss IntegrityM’s UPIC data analysis services call (703) 991-6179 or click here to fill out our online contact form.

How can our UPIC data analysis services help you?
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When conducting UPIC data analysis, experience in the field is irreplaceable. Not all data are alike, and analyzing healthcare data requires fluency in HCPCS, CPT, and ICD coding processes. Performing UPIC data analysis requires data analysts who thoroughly understand Medicare, Medicaid, and all the various facets of both programs.

UPIC data analyses, like UPIC Investigations, are as much an art as they are a science and are the center of the UPIC process. Claims data analysis contributes to and instigates action in the other UPIC phases: Medical Review, Investigation, or Audit.

When deliberating which team adds the most value to your Data Analysis process, past performance is the most important consideration. Experience, reliability and proven performance in claims data analysis are vital in determining aberrant billing patterns.

UPIC Data Analysis Services at IntegrityM

Each member of the IntegrityM data analysis team is a seasoned professional with experience analyzing Medicaid and Medicare Parts A, B, C, D, Home Health, and DME data.

The IntegrityM Data Analytics Team includes data analysts, data managers, data scientists, statisticians and subject matter experts (SME) who align with the UPIC statement of work:

  • Expertise and innovation in developing proactive data analysis
  • Statistical depth and sophistication (multivariate regression, cluster analysis)
  • Proficiency in SAS, Business Objects, SQL Server, Web Development, MS Access, MS Excel, and OnePI fuzzy-matching
  • Development of fraud, waste, and abuse detecting models and algorithms
  • Statistical Sampling and Extrapolation using both SAS and RAT-STATS (access to SME’s that developed RAT-STATS software)

Our team’s experience with claims data mining and analysis, payment policies, and Affordable Care Act fraud allow them to convert large data-sets into actionable information. They consult with clients to meet their needs and goals while keeping sensitive data safe. Additionally; our team can be used as expert witnesses and other support for Administrative Law Judge (ALJ) Hearings.


Contact IntegrityM for more information about our UPIC data analysis services or to discuss potential partnering opportunities.

To speak with one our experts about our claims data mining and analysis services, click here to contact us today, or call (703) 991-6179.


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