Case Study: Major Healthcare Company achieves $6M annual fraud recovery with SymphonyAI

Discovering Fraud in Huge Noise

Major Healthcare Company, a Fortune 500-ranked global healthcare organization, was struggling to analyze complex transactional data and reduce the financial impact of overpaid erroneous claims and delayed collections. They needed SymphonyAI to help them become more dynamic in their analysis, strengthen fraud detection, and build better behavioral models with in-house expertise they lacked.

After a successful proof of concept, SymphonyAI implemented its platform to improve fraud lead generation and identify key characteristics of unfavorable claim behavior. The solution helped the company cut lead generation turnaround time by 7x and deliver conservative annual savings of $6 million by recovering lost fraud dollars, while also reducing excess claims leads.