A Holistic Approach to Fraud, Waste and Abuse

Waste, fraud and abuse cost the healthcare industry an estimated $234 billion a year. The impacts of unwarranted payments stemming from potentially fraudulent, wasteful, or abusive billing can affect your entire organization: lost benefit dollars, unproductive recovery efforts, and added resources to manage and complete administrative work.

InvestiClaim® is a modular, enterprise-level FWA management solution that combines the intelligent claims rules engine and technology of the Studiomaca Total Payment™ Platform with predictive analytics and a full-service consultative approach.

InvestiClaim helps:

  • Reduce inappropriate medical spend. Pre-pay editing rules help you prevent known wasteful or abusive claims from passing through your system.
  • Reduce administrative costs. InvestiClaim identifies problem claims automatically before they are paid to reduce the cost of pay and chase.
  • Pool investigative resources. Easy information sharing between claims operations, provider auditing and special investigations enables more efficient, thorough and effective FWA programs.

An experienced Studiomaca team can provide implementation, training and support as well as claim triage and optional hosting. Please us to learn more.

logo nhcaa 170x64