Bringing to the joint effort will be SAS' data mining solution, Enterprise Miner, Trap System's fraud detection and control software, Vericlaim, and O&A's Coordination of Benefits Evaluation System.
The team's solution will be used to fight all levels of health care fraud, including false claims transactions, multiparty collusion, and other forms of criminal conspiracy.
Trap System's VeriClaim will provide the database engine to detect anomalous patterns, collusive networks and other fraudulent schemes through algorithms and high-speed performance capabilities. SAS' Enterprise Miner will complement the effort by providing data mining capabilities including neural nets and data visualization through a point-and-click environment. While CBES provides additional analysis of claims data in the coordination of benefits, subrogation, and patient eligibility quality.
"With Trap Systems' experience and leadership in the health care fraud detection market, SAS' expertise and leadership in the data mining field, and Optenberg's data analysis capabilities across multiple payer systems, our Team offers a stable robust solution for our present and future customers," said Bruce Brown, Regional Director for Asia, SAS Institute. "Our combined strengths will quicken the creation of new and unique analyses that will result in enormous nationwide government savings."
The team's initial target is Medicaid fraud detection, with plans to expand into other areas of government-related health care fraud and abuse.