Text Mining for Fraudulent Patterns

Using an approach of text mining of claim diaries, Magnify introduces a new product called, FraudFocus. 

FraudFocus^TM, Magnify's predictive modeling-based claims fraud product, continuously reviews claims, beginning at first notice of loss and thereafter whenever a claim is updated throughout the entire life of the claim. The "heart" of the FraudFocus^TM approach is predictive modeling, which relies on advanced statistical analysis of claims data to develop algorithms (models) that can accurately identify claims likely to be fraudulent. Predictive modeling is a proven fraud detection technology. In the credit card industry, predictive modeling has been utilized for years to reduce fraud losses by 30% or more. Opportunities exist in Worker's Comp to apply predictive models in a similar manner to identify claimant fraud, provider fraud and policy fraud simultaneously.

Couple this approach with a streaming feed of medical bill analysis, and the possibilities are endless.