Health Care


By Segment

By Capability

LexisNexis post-pay solutions help payers detect overpayments by applying thousands of rules across various claim types, including medical, facility, pharmacy and dental; prioritize and optimize the use of investigative resources using a proprietary scoring system, calculated from the level of suspicion and the exposure; identify providers who habitually submit problematic claims and empower more informed choices through a comprehensive detailed view of provider and member data.

Additionally, LexisNexis offers supplemental SIU services enabling customers to leverage an additional team of experts, ease the transition from post-pay into pre-pay and reduce overall operational costs by transitioning SIU responsibilities to LexisNexis.

  1. The Real Cost of Health Care Fraud - And New Ways to Fight It
    Stopping the Flow of Health Care Fraud with Technology, Data and Analytics
  2. Key Factors for Payers in Fraud & Abuse Prevention
    Protect against fraud and abuse with a multi-layered approach to claims management
  3. Public Records for Health Care
    Reduce exposure to claims fraud with integration of public records
  4. Bending the Cost Curve: Analytic Driven Enterprise Fraud Control
    Three percent, or $60 billion, of all health care spending is lost to fraud.
  5. The Rise of Organized Crime in Health Care: Social Network Analytics Uncover Hidden and Complex Fraud Schemes
    Experience the power of data, linking and analytics
  6. Enhanced data for more powerful fraud prevention

Accurint® for Health Care
Protect against fraudulent claims and identity fraud
Intelligent Investigator™
Pinpoint fraud with confidence
Provider Integrity Scan
Know your providers, reduce risk, and prevent fraud.
Provider of Interest Score
Identify aberrant patterns in provider behavior
Relationship Mapping
Identify hidden relationships that may indicate fraud
Trail Tracker™
Track cases and improve recovery
Virtual SIU™
Grow your investigative capabilities