pondera case management

Pondera has significant experience in managing tenders for renewable energy projects involving wind energy, solar energy and/or geothermal energy. This includes completeness, referential integrity, usability, and stability to identify specific problems in client and third-party source data.Our industry experts are happy to provide an in-person or web conference overview that is customized to your organization and your needs. The new case management system has improved business processes and data gathering for the 366B. Data is vetted prior to analysis with our proprietary data profiler tool and assessed for completeness, efficacy, consistency, and usefulness.Fully-integrated investigative case management imports cases from the fraud detection module or other sources and uses workflow and rules engines to route cases through your resolution process. Data is vetted prior to analysis with our proprietary data profiler tool and assessed for completeness, efficacy, consistency, and usefulness.Fully-integrated investigative case management imports cases from the fraud detection module or other sources and uses workflow and rules engines to route cases through your resolution process. We are therefore well acquainted with all laws and regulations that a maintenance party and supplier manager must meet. This includes completeness, referential integrity, usability, and stability to identify specific problems in client and third-party source data.Our industry experts are happy to provide an in-person or web conference overview that is customized to your organization and your needs. The mobile application allows field investigators to review, record, and track cases while in the field.Pondera analyzes the fitness of your data specifically for its use in fraud detection analytics. Review return on investment by month, quarter, or yearPondera ingests your program data, matches it against third party data sources, and then runs it through a series of procedural and prediction models to detect previously known and unknown anomalies and patterns.Program data and 3rd party data are ingested and run through procedural and prediction models to detect previously known and unknown bad actors, schemes, and patterns. Using team performance analytics, managers can allocate program integrity resources and view the results of their enforcement …

Using a combination of third-party databases, rules-based analysis, prediction algorithms, and machine learning, the system can help federal government agencies validate program beneficiaries, service providers, and discrete transactions. As a result, Nevada’s investigation and recovery team is more efficient and effective.” BILL STRONG – Chief of Investigations and Recovery, Designed to avoid provider abrasion but ensure effective program oversight, Pondera’s Special Investigations Unit helps design and tune the algorithms and brings context to the analytics, enabling your auditors and investigators to understand the reasons behind an alert or fraud risk score.Pondera is used in both managed care and fee-for-service programs including Medicaid, Medicare, and commercial markets with specialized detection models for healthcare programs.
Pondera’s system provides payment integrity services through pre-payment and post-payment analytics on providers, beneficiaries, claims, and members for both fee-for-service and managed care organizationsAll aspects of Pondera’s system are built to handle the massive data sets found in healthcare including smart link charts to view large networks of providers and beneficiaries/members, and scorecards to triage leads and prioritize enforcement activities.Pondera combines hundreds of healthcare-specific detection algorithms to identify issues such as doctor shopping for opioids, duplicate payments, unbundling, up-coding, unnecessary procedures, and unusual travel patterns. With pre and post payment surveillance, provider and beneficiary/member review, and a full array of analytics and third party data to augment your claims and encounter data, the Pondera solution provides cutting-edge Fraud, Waste and Abuse monitoring. “Pondera’s FraudCaster system has been instrumental for fraud and trafficking detection. The mobile application allows field investigators to review, record, and track cases while in the field.Pondera analyzes the fitness of your data specifically for its use in fraud detection analytics. Using team performance analytics, managers can allocate program integrity resources and view the results of their enforcement actions.Managers use FraudCaster® to review Trends, patterns, clusters, and individual leads with their team with a comprehensive view of program participant’s eligibility information, alerts, behaviors, and transactions.Our Special Investigations Unit provides intel reports to help support your efforts in particularly complex casesCase management system integrates fraud alerts and enables workflow, case tracking, and reporting Pondera can be used for both pre-payment and post-payment program integrity enforcement. This helps the government …

Pondera’s fully integrated case management system, CaseTracker™, manages case information, reports on case status and investigator progress, and feeds the results back to the front-end analytics to continually improve detection accuracy Managers review analytics, case progress, and outcomes with Pondera.

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