Data Mining and Lead Generation

Proactive data analysis has an exponential impact on the success of an SIU and often results in substantial recoveries, improved business processes and significant savings over time. But it also requires the right skill set to achieve the desired results.

Integrity Advantage has the skills, experience and staff to mine data from whatever platform your organization utilizes across medical, dental, pharmacy or facility claims. Our investigators quickly adapt to any software or analyze raw claims detail to identify leads and substantiate allegations of FWA, including detailed analysis of payment history, identification of suspect behavior, and recommend courses of action. Our professionals have built a career in outlier detection and presentation across Medicaid, Medicare, FEHB, self funded and commercial lines of business. 

Lead Generation

Integrity Advantage provides lead generation and assessment services in order to allow your team to focus on their existing workload. Our lead generation support aims to deliver opportunities that are vetted and ready to be assigned to an investigator. Templates are customized by client and include, but are not limited to:

We compile all of this info and more to present to you in a clear and organized package, ready to be assigned to your staff. We also offer investigative support if your team already has a full plate. See our Investigations services here. Our support can include statistical sampling and extrapolation for healthcare organizations who may need assistance in these areas.

If your team has enough work and doesn’t have the time to mine data or use your existing anti-fraud solution to find proactive opportunities for investigation, this may be the perfect solution for you.