Ask the Fraud Agent
Example questions
Investigation Response
Ask a question to begin. The agent returns prioritized risk indicators over the Medicare Intelligence | Claim Risk Profile data product.
AI-powered investigation over governed claim risk data products.
Investigators can ask natural-language questions over governed Medicare claim risk data to identify suspicious claims, provider behavior, duplicate billing, upcoding, eligibility issues, and payment leakage.
Find claims with suspicious billing, duplicate claims, upcoding, and excessive units.
Identify paid claims that may require recovery, review, or policy validation.
Prioritize claims and providers for investigator review using governed data products.
Ask a question to begin. The agent returns prioritized risk indicators over the Medicare Intelligence | Claim Risk Profile data product.
Claims, patients, providers, payments, eligibility and authorizations.
A fused data product that resolves and scores every claim.
Policy applied at the point of use, with full lineage.
Natural-language investigation over governed data.
Prioritized, explainable cases ready for review.