Claims, Health Insurance

Battling Health Insurance Claims Fraud

July 18, 2023

Battling Health Insurance Claims Fraud
Insurance companies and providers of health care benefits lose hundreds of millions of dollars yearly due to fraudulent claims for health benefits. Some of these are bogus claims that originate from insured persons, while others are payments for insured services that are not needed but are wrongly prescribed by providers who stand to make illegal profits.

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HPOne

Here at HPOne, our focus on the health insurance industry brings proprietary technology, along with innovative and performance-based solutions, to address the most pressing challenges facing our clients. Follow our LinkedIn page for updates on company events, job postings, and insights into our employee culture.

OTHER WHITEPAPERS
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A Simple Explanation of How AI Can Be Used in Insurance

whitePaper | August 1, 2022

As the saying goes, “practice makes perfect.” In other words, people learn from experience. According to the Oxford Dictionary, “regular exercise of an activity or skill is the way to become proficient in it, especially when encouraging someone to become persistent in it.” While practice cannot truly make someone perfect in any industry or activity, persistence does usually lead to increased proficiency, and seasoned practitioners typically outperform those who are just starting out.

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Guidewire Testing Framework for Autonomous Testing

whitePaper | May 9, 2022

The pace of change driven by digital transformation is rapidly increasing as new generations of agile competitors emerge. Insurance businesses, too, are evolving to keep pace with the latest business trends and update their products and services.

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Top Insurance Industry Issues in 2019

whitePaper | November 29, 2019

Insurance carriers have invested a great deal in digital capabilities in recent years. While these initiatives reflect a genuine need to be more efficient and profitable, it can be difficult for management to maintain a clear perspective on strategy in the face of what amounts to generational change. Accordingly, whether you’re embarking on a digital transformation or just making targeted improvements, there are a few important things to keep in mind.

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The role of wearables in private medical insurance

whitePaper | March 9, 2020

Ever since the rollout of electronic devices capable of measuring and recording various types of health data, private medical insurers have been carefully eyeing the potential usage of these devices. This paper discusses the implementation and practical uses of wearable technology in the private medical insurance market.

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How Bond Insurance Delivers Value for Investors: In The Pandemic And Beyond

whitePaper | July 31, 2022

The Covid-19 pandemic spurred new demand for insured municipal bonds, and the strong interest appears poised to continue as investors team with states and local governments to help execute the largest wave of U.S. infrastructure investment in a generation. Amidst the uncertainty surrounding municipal fiscal stability and an increase in taxable debt issuance immediately following the outbreak, wrapped bonds offered investors stable ratings, increased liquidity and less volatility. Since then, the market has faced more prolonged volatility brought on by questions about the outlook for inflation, economic growth, and other factors like climate change. Insurance remains a valuable tool for investors and issuers to maintain reliable, affordable capital markets access and peace of mind.

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Understanding the NAIC Insurance Data Security Model Law

whitePaper | September 10, 2022

State governments, not federal agencies, have preeminence over the insurance industry (as defined by the McCarran-Ferguson Act of 1945). Thus, it is up to each state to pass and enforce laws governing insurance companies. Each state has its own chief insurance commissioner to manage this function.

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Spotlight

HPOne

Here at HPOne, our focus on the health insurance industry brings proprietary technology, along with innovative and performance-based solutions, to address the most pressing challenges facing our clients. Follow our LinkedIn page for updates on company events, job postings, and insights into our employee culture.

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