Leading Insurers Now Leverage Quantifind’s Graphyte™ Platform With ProviderSafe™ Data for fraud detection and investigations
Medical disciplinary records within Graphyte bolsters efficiency, timeliness, and reliability for fraud decision-making.
PALO ALTO, CALIF (November 14, 2022) — Quantifind announced the inclusion of new premium datasets to its AI-powered automation platform, Graphyte™, to accelerate healthcare fraud investigations within the financial services industry. ProviderSafe™, powered by Typhoon Data, supplements the Graphyte suite of intelligence solutions with premier healthcare credentialing, sanctions, exclusions, and compliance data designed to kick off investigations and maximize the impact of users’ risk screening and investigative workflows.
Leveraging Quantifind’s AI and technology stack, Graphyte provides teams with rapid and accurate reporting. With a click, Graphyte ranks results by risk and confidence from over 10,000 data sources and is proven to reduce false positives significantly, allowing analysts to focus on relevant data to prioritize high-risk cases while minimizing distractions.
Through its innovative data collection processes, state-of-the-art algorithms and integrations, ProviderSafe delivers primary-source records from the Office of the Inspector General (OIG), System for Award Management (SAM), state Medicaid exclusions, Medicare opt-out, board actions from all 50 states, and other federal sources. ProviderSafe integrates new data as each primary source updates, and meticulously constructed source lists reduce the instances of duplicates, significantly decreasing turnaround time and dead-end investigations.
The combination of Graphyte’s advanced investigation tools and ProviderSafe’s compliance and sanctions data takes internal investigative processes to the next level. With consolidated analysis and results in Graphyte’s single intuitive investigation interface, users also have visibility to potentially adverse media news articles featuring alleged malpractice, Yellowpages listings, state exclusions, and other records of relevance to one’s search. Company intelligence data is included, allowing a structured view of officers, owners, and related companies to the medical facility.
The ProviderSafe suite of solutions is powered by Typhoon Data and has received certification from the National Committee for Quality Assurance (NCQA) for the following key credential verifications and services: License to Practice, DEA Registration, Medical Board Sanctions, Medicare/Medicaid Sanctions, and Ongoing Monitoring.
“With this enhancement, the Graphyte platform provides a best-in-class user experience, a richer feature set, more dynamic workflows, and automated reporting to improve crime risk screening, fraud detection, and investigative performance,” said Graham Bailey, COO at Quantifind. “The inclusion of ProviderSafe will increase the speed at which insurance investigators, analysts, and researchers can evaluate medical personnel and facilities or further investigate questionable credentials. Combined with superior data science for entity resolution to reduce false positives, investigative teams can see an upwards of 40% in productivity gains.”
More information about the features and benefits of AI-driven, intelligent financial crimes automation to support internal investigations into fraud, waste, and abuse can be found at Quantifind’s website.
Quantifind's Graphyte AI-powered financial crimes automation platform applies comprehensive data coverage, best-in-class risk assessment accuracy, and powerful investigation tools to deliver AML-KYC productivity gains of over 40%.
Watchlist Screening | Investigation | Adverse Media Screening | Credit Risk