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Shift Technology to help HICFG develop health insurance counter fraud database

Published 12 July 2018

Shift Technology has been selected by H I Counter Fraud Group (HICFG) to develop a health insurance counter fraud database.

Delivery and production use of the database are on schedule for September, 2018.

While HICFG already had a counter fraud database in place, the association’s needs had matured and continue to change, prompting the need to look at available new options and for an industry partner able to provide a modern, quality, flexible, and fully compliant database for use by the organization’s members today and for the foreseeable future.

Citing Shift’s reputation, commitment to and focus on insurance claims fraud detection, and the company’s expertise in data management, HICFG selected Shift Technology for the project.

HICFG steering committee member and database project leader George Paxton said: “We had heard a lot of good things regarding Shift Technology’s experience in insurance fraud detection.

“After learning more about their capabilities and commitment to helping mitigate losses due to fraud detection, we felt they were a natural fit to assist us with our new database needs.”

Set-up of the new health insurance counter fraud database is already underway and, once completed, will provide HICFG members with a structured data system which permits authorized users to log relevant and key details, update other users through an alert system, and enable users to interrogate the database with agreed upon parameters.

Additional key features the database will offer to HICFG members include:

Enable members throughout the EU and globally to participate in data logging, interrogation and extraction.

Development, administration, and maintenance of an audit trail of all data input and searches undertaken, and made accessible to specified users with “administration” or “super-user” rights.

Provide the ability to readily share best practice and emerging themes.

Offer the capability to easily publicize counter-fraud activity within travel and healthcare.

Provide alerts and intelligence to the group members from 3rd parties, such as clinical regulatory bodies and others.

Give members the ability to alert all users of a new case.

Shift co-founder and CEO Jeremy Jawish said: “This is a great win for Shift and gives us a strong foothold in the UK health industry and with an industry association.

“Insurance fraud continues to pose a significant and common challenge to insurance entities, and joining forces and collaborating as an industry through relationship likes this offers all stakeholders the best path to minimizing the impact of fraud.”

Source: Company Press Release