MARKETS

BSE Prices delayed by 5 minutes... Prices as on Jun 19, 2018 - 10:02AM   ABB India 1198 [ -1.38% ]ACC 1290.05 [ -0.72% ]Ambuja Cements Ltd. 202.05 [ -0.66% ]Asian Paints Ltd. 1279.95 [ 0.25% ]Axis Bank Ltd. 519.75 [ -0.44% ]Bajaj Auto Ltd. 2880.55 [ -0.74% ]Bank of Baroda 131.4 [ 0.38% ]Bharti Airtel 373.9 [ 0.71% ]Bharat Heavy Ele 76.15 [ 0.26% ]Bharat Petroleum 411.55 [ -2.70% ]Britannia Ind. 6036.3 [ -0.66% ]Cairn India Ltd. 285.4 [ 0.90% ]Cipla 608.1 [ 0.35% ]Coal India Ltd. 274 [ -0.22% ]Colgate Palm. 1199.5 [ -0.30% ]Dabur India 384.85 [ -0.38% ]DLF Ltd. 200.5 [ 0.38% ]Dr. Reddy's Labs 2421 [ 1.71% ]GAIL (India) Ltd. 339.6 [ 0.41% ]Grasim Inds. 1004.5 [ -1.56% ]HCL Technologies 924.8 [ -0.95% ]HDFC 1819.45 [ -0.29% ]HDFC Bank 2024.1 [ 0.14% ]Hero MotoCorp 3630 [ -1.05% ]Hindustan Unilever L 1599.95 [ -0.62% ]Hindalco Indus. 231.3 [ 0.04% ]ICICI Bank 291.8 [ -0.24% ]IDFC L 49.2 [ -0.40% ]Indian Hotels Co 134.4 [ -0.22% ]IndusInd Bank 1953.5 [ -0.72% ]Infosys 1245.4 [ -1.67% ]ITC Ltd. 263.85 [ -0.11% ]Jindal St & Pwr 230.7 [ 0.52% ]Kotak Mahindra Bank 1311.4 [ -0.20% ]L&T 1318 [ -0.39% ]Lupin Ltd. 917.9 [ 1.73% ]Mahi. & Mahi 912.7 [ -0.01% ]Maruti Suzuki India 8927.65 [ -0.73% ]MTNL 17.15 [ -0.29% ]Nestle India 9662.75 [ 0.40% ]NIIT Ltd. 98.55 [ -1.05% ]NMDC Ltd. 112.2 [ -0.13% ]NTPC 155.2 [ -0.96% ]ONGC 165.25 [ 0.55% ]Punj. NationlBak 89.35 [ 1.07% ]Power Grid Corpo 197.7 [ -0.60% ]Reliance Inds. 1011.6 [ -0.33% ]SBI 276 [ -0.31% ]Vedanta 228.2 [ -1.76% ]Shipping Corpn. 64.2 [ -0.16% ]Sun Pharma. 574.55 [ 0.65% ]Tata Chemicals 729.35 [ -0.59% ]Tata Global Beverage 269.85 [ -1.80% ]Tata Motors Ltd. 310.55 [ 0.58% ]Tata Steel 561.9 [ 0.57% ]Tata Power Co. 74.8 [ -0.53% ]Tata Consultancy 1831.45 [ 0.04% ]Tech Mahindra Ltd. 707.75 [ -0.30% ]UltraTech Cement 3638.65 [ -0.83% ]United Spirits 676.85 [ 1.56% ]Wipro Ltd 262.4 [ -1.20% ]Zee Entertainment En 558 [ -0.50% ]

News Details

You can view in detail.
Wipro launches solution for fraud and abuse in US healthcare insurance claims 13/06/2018 09:12

IT bellwether Wipro on Tuesday launched an end-to-end solution to address the issue of fraud, waste, and abuse in healthcare insurance claims in the United States, in partnership with Opera Solutions, LLC. Opera Solutions LLC is a global leader in applied Big Data analytics and artificial intelligence (AI).

“The solution will combine Opera Solutions’ powerful AI and machine learning based Fraud, Waste and Abuse (FWA) detection engine with Wipro’s extensive full-service claim processing capabilities in claims review, which includes the forensic examination of questionable claims, audits, adjustments, negotiations, recovery follow-up and payment posting,” Wipro said in a press release.

Opera Solutions’ FWA detection engine leverages proprietary entity risk scoring algorithms that significantly outperform traditional rules-based methods. While existing approaches primarily search for irregularities on a claim-by-claim basis, Opera Solutions’ detection engine goes far beyond claims to identify anomalous treatment patterns for every healthcare entity, i.e., all healthcare providers and physicians across major medical specialties. This approach will substantially improve the identification rate of high-risk claims and reduce the number of false positives, or flagged claims that are in fact, legitimate.

Wipro’s claims auditors can thus begin their work with a far more accurately prioritized list of claims to review, along with a detailed background and reason codes for flagged claims, thereby, enhancing their efficiency and reducing claims review turnaround time. It reduces the admission of non-allowable claims, as well as customer dissatisfaction arising out of the holdup of legitimate claims that were flagged, erroneously. This will help healthcare organizations focus on delivering high-quality care in the most efficient manner possible.

“As one of the global leaders in healthcare insurance claims services, we are aware of the many limitations of automated rules-based systems for first-line claims review,” said Nagendra Bandaru, Senior Vice President and Global Head - Business Process Services, Wipro Limited. “Opera Solutions’ powerful entity-based AI-powered approach, when combined with Wipro’s deep claims management expertise, will give us an edge in the market and enable us to create tremendous value for health insurers.”

Arnab Gupta, Chief Executive Officer and Founder of Opera Solutions said, “Our strategic relationship with Wipro is a perfect example of the ways in which advanced pattern-based AI and machine learning can allow talented and highly experienced people to become even more effective at what they do. We look forward to working with Wipro to take this powerful new capability to the market.”

LOAD MORE