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Stop Guessing, Start Knowing. Predictive analytics is key to efficiently detecting, preventing, and correcting fraud.

Predict and intervene: expedite results

Manually fighting fraud is expensive, consuming the time of employees. Though vital to business operations, this process is inefficient and ineffective, hurting those who do nothing wrong. A powerful data mining solution can shorten this process, helping both employees and clients. A predictive intelligence platform can catch fraud earlier, with less labor, and highly accurately… and help you improve your bottom line.

  • Fraud Detection and Protection
  • Program Eligibility
  • Underwriting

Every day, standard methods of fraud detection eat up companies’ time, driving up costs elsewhere for themselves and for clients in order to make up for the wasted labor. Digging through documents to sort out claims, eligibility, returned merchandise, or erroneous contracts hurts you in the long run, but is highly preventable. Predixion’s goal is to help your employees use their time as efficiently as possible, while still bringing you accurate and timely results.

Here’s how it works:

  • Use multiple enterprise data sources — claims and demographic — for highest accuracy
  • Build predictive model using Predixion Insight platform
  • Run model in real-time to risk score claims within segmented profiles
  • Display scores and interventions in custom portals or push to existing LOB systems at the decision point

Predixion Insight can prevent and better detect fraudulent claims and contracts, while also quantifying successes and improvements by tracking outcomes — all without requiring technical knowledge of data mining and forecasting. Actionable insights and integration allow for a single view of average accounts, segments, values, and risks. Overall, our platform can increase operational efficiency and reduce losses in your business by predicting and intervening on fraud.


When determining program eligibility, mistakes can not only waste millions of dollars on ineligible participants, but more importantly hurt those that the program is designed to help. In managing these programs, you face a constant choice: spend massive amounts of time on stringent, extremely thorough eligibility inspections – diverting hundreds of thousands of dollars in labor from helping qualified participants – or risk wasting money on people who fraudulently enter the program. Predixion can increase accuracy and decrease processing time, freeing up resources to help those who need it most.

Here’s how predictable program eligibility works:

  • Integrate historical data into Predixion Insight to find trends and establish rules
  • Build predictive model using Predixion Insight platform
  • Run model in real-time to segment applicants and apply risk-scores based on likelihood of ineligibility
  • Display scores at the decision point in custom portals, so employees can optimize their schedules and resources
  • Model updates in real-time, so rules and identified trends are always relevant and accurate

Predixion Insight can streamline monitoring program eligibility, track outcomes and update scores in real-time. The risk scores allow investigators to work more efficiently without any technical knowledge of predictive analytics or machine learning. Overall, our platform can increase accuracy and save time in identifying ineligible applicants, while well-qualified applicants enter the program with minimal friction.

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