About
Healthcare Fraud Shield offers the HCFSPlatform, an AI-driven suite for healthcare payers to detect and prevent fraud, waste, abuse, and error (FWAE). The platform enables payment integrity (PI) and special investigations unit (SIU) teams to investigate pre- and post-payment claims using AI-driven anomaly detection, a proprietary data fusion library, and a rules engine. The vendor describes end-to-end solutions that include auditing, SVRS, and medical record retrieval. Messaging emphasizes enhancing payment integrity, ensuring compliance, and delivering ROI for health plans. The site positions HCFSPlatform as a product selection experience to match organizations to specific fraud-detection needs such as pharmacy fraud, pre-pay detection, audit accuracy, and automation.
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