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FRAUD, WASTE & ABUSE

SKYGEN USA helps payers manage the risk of fraud, waste and abuse with AI analytics.

SKYGENUSA Powering Healthcare for the Digital Age

Millions of dollars are lost to fraud, waste, and abuse (FWA) each year, putting plan performance and stakeholder satisfaction at risk. SKYGEN USA moves the power to reduce and prevent FWA into the hands of payers with AI analytics that identify outliers within the payer’s network. Armed with data on providers who are over- or under-treating patients, payers have the option to educate them on better practices and appropriate care rules. SKYGEN’s analytics also uncover high-performing providers, enabling payers to reward them with higher levels of referral and or reimbursement. Together, SKYGEN USA and payers can reduce the risk of FWA and improve network performance and program outcomes.

 

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