Who are our clients?
Beyond Compliance serves a wide range of clients: from data scientists and fraud investigators, to hospital systems, pharmacies, and healthcare insurance companies.
-Healthcare insurance companies
-Special Investigation Units
-Medicare/Medicaid fraud prevention
-Medical staffing agencies
-Hospital hiring managers
Large Insurance Companies leverage our database in the pre and post audit phases of claim processing. By merging medical claims data against our database, providers with a criminal past can be flagged and their claims moved to auto-deny status. Applying auto-deny edits saves MILLIONS of dollars and is more effective than the pay-and-chase model.
Hospital hiring managers, medical staffing agencies, and provider credentialing firms use our database to supplement the background screening process. Because our database includes current press releases and data from all states, it is harder for providers and staff with a fraudulent past to fly under the radar.
Data Scientists leverage our data for training predictive models and machine learning algorithms. Using our database, data scientists now have a much larger universe of fraud cases with which to work. Fraud is a very rare occurrence in "Big Data" so it is critical to have as many data points as possible for training predictive models.