Verisk, a Jersey City-based data analytics provider, announced on Tuesday that the National Insurance Crime Bureau has renewed its contract to host and maintain the Aggregated Medical Database.
The contract, which now has been renewed for a third time, has resulted in the development of AMD’s platform, which identifies medical provider fraud for NICB and its member companies.
“We’re committed to delivering the highest-quality service, and our ongoing collaboration with Verisk is yet another reason NICB continues to be the thought leader when it comes to insurance fraud and theft,” Joe Wehrle, CEO and president of NICB, said. “It’s in the best interest of NICB, our members, and law enforcement partners to use medical and prescription billing data to create innovative solutions that combat medical fraud.”
Through the partnership, Verisk said it has developed ISO MedSentry, a predictive analytic tool that detects potential fraud, waste and abuse across an insurer’s entire business.
“Our predictive analytics are applied to the AMD’s contributory information to quickly discover markers of potential fraud, waste, and abuse in medical billing data,” said Richard Della Rocca, president of ISO Claims Analytics, a Verisk business. “This large-scale analysis produces actionable reports that allow NICB to create MedAWARE Alerts that identify suspicious providers that may be negatively affecting their members’ claims costs.” Della Rocca added, “We’re proud of our near 50-year commitment to fighting fraud, and our partnership with NICB strengthens our efforts focused on exposing medical provider fraud.”
