FraudLens AI
FraudLens is an AI-powered healthcare fraud detection and prevention software solution that uses Multi-Vectored technology to identify and prevent fraud, waste, and abuse (FWA) within 24 hours before payment.
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Product Information
Updated:Dec 1, 2025
What is FraudLens AI
FraudLens is a revolutionary automated healthcare fraud detection system specifically designed to reduce financial burden from both high-volume/low-dollar and low-volume/high-dollar fraud, waste and abuse (FWA). It represents a paradigm shift from traditional 'pay and chase' methods to a smart, automated 'detect and prevent' model for healthcare payers. The solution combines informatics, clinical expertise, forensics, information technology, and advanced data visualization to create a comprehensive fraud prevention system.
Key Features of FraudLens AI
FraudLens is a comprehensive healthcare fraud detection and prevention solution that combines informatics, clinical expertise, forensics, IT, and advanced data visualization. It operates in near real-time, providing results within 24 hours through its Multi-Vectored technology, enabling healthcare payers to shift from a traditional 'pay and chase' model to an automated 'detect and prevent' model for both high-volume/low-dollar and low-volume/high-dollar fraud, waste, and abuse (FWA) cases.
Near Real-Time Detection: Processes and reports FWA cases within 24 hours pre-payment and pre-adjudication
Multi-Vectored Technology: Utilizes miniature expert systems to analyze all claims data daily
Comprehensive Reporting: Provides detailed reports identifying who committed FWA, what was fraudulent, when and where it happened, and how it occurred
Automated Prevention: Shifts from manual review to smart, automated detection and prevention model
Use Cases of FraudLens AI
Healthcare Claims Processing: Prevents fraudulent medical and dental claims before payment processing
High-Volume FWA Detection: Handles more than 90% of all FWA cases involving high-volume, low-dollar transactions
Healthcare Payer Operations: Enables healthcare payers to increase savings through automated fraud detection and prevention
Pros
Quick response time with 24-hour reporting
Handles both high-volume/low-dollar and low-volume/high-dollar fraud cases
Comprehensive integration of multiple technologies and expertise
Cons
Primarily focused on healthcare sector
Requires significant data integration and setup
How to Use FraudLens AI
No detailed steps available: The provided search snippets do not contain specific instructions on how to use FraudLens AI. Please consult official FraudLens documentation or contact their support team for accurate usage guidelines.
FraudLens AI FAQs
FraudLens is a near real-time healthcare fraud, waste, and abuse (FWA) automated detection and prevention software solution. It uses Multi-Vectored technology with miniature expert systems to analyze claims data daily and detect both high-volume, low-dollar and low-volume, high-dollar FWA.
FraudLens AI Video
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