Medical Fraud Detection Management Market by Type (Descriptive Analytics, Predictive Analytics, and Prescriptive Analysis), Component (Software, and Services), Delivery Mode (On-Premise, and On-Demand) Application (Insurance Claims Review, Payment Integrity, and Others) and End User (Private Insurance Payers, Public/Government Agencies, Employers, and Third Party Service Providers): Global Opportunity Analysis and Industry Forecast, 2018–2025
|
LI_195629
|
Pages: NA
|
Nov 2019 |
30 Views
|
|
|
|
Author(s) :
NA
|
Tables: NA
|
Charts: NA
|
Formats*:
|
|
Medical fraud is increasingly apperceived as one of serious social concerns. Healthcare fraud is a problem for the government and there is a need more effective detection method; which requires great amount of efforts with proper medical knowledge. Traditionally healthcare fraud detection greatly depended on the experience of domain experts, which is erroneous, expensive, and time consuming. Manual detection of healthcare fraud involves a few auditors who manually review and identify the suspicious medical insurance claims, which requires much effort. However, with the advancement in machine learning, and data mining techniques there is a way for more efficient and automated detection of healthcare frauds. There has been a growing interest in mining healthcare data for fraud detection in the recent years.
Medical fraud detection management market actually helps in preventing healthcare fraud, waste, and abuse. Healthcare fraud is completely a misrepresentation or intentional deception of facts by healthcare professionals or patients, which can be lead to unauthorized payments or benefits. Some examples of healthcare frauds are including falsified data by physicians, multiple claims filed by different providers for the same patients, submitting claims for services which are not provided, misrepresenting dates in various treatments, frequency, and duration or description of services provided.
The increase in number of fraudulent activities in healthcare, rise in the number of patients seeking healthcare insurance are the major driving factors for the growth of medical fraud detection management market. Moreover, the increase in pressure of fraud cases, waste, and abuse on healthcare spending are also expected to boost the growth of the market. However, the lack of skilled professionals and reluctance to adopt these fraud analytic systems in developing countries can restrain the market growth. The advancement in cloud-based analytics and development of AI techniques for healthcare fraud detection will help to open new avenues for the growth of medical fraud detection management market.
The medical fraud detection management market is segmented based on type, component, delivery mode, application by end users and region. Type wise, the healthcare fraud detection management market is segmented in descriptive analytics, predictive analytics, and prescriptive analytics. Based on component, the medical fraud detection management market is segmented into software and services. By the mode of delivery, the market is segmented into on-premise and on demand. Application wise, the medical fraud detection management market is segmented in insurance claims review, payment integrity, and other applications. The market is segmented by end users into private insurance payers, public/government agencies, employers, third party service providers. Region wise, the medical fraud detection management market has been analyzed across North America, Europe, Asia-Pacific, and LAMEA.
The key players of medical fraud detection management market include - IBM, Optum, Verscend Technologies, McKesson, Fair Isaac, SAS Institute, HCL Technologies, Wipro, Conduent, CGI Group.
KEY BENEFITS FOR STAKEHOLDERS
- This report provides a detailed quantitative analysis of the current healthcare fraud detection management market trends and forecast estimations from 2018 to 2025, which assists to identify the prevailing opportunities.
- An in-depth market analysis includes analysis of various regions is anticipated to provide a detailed understanding of the current trends to enable stakeholders formulate region-specific plans.
- A comprehensive analysis of the factors that drive and restrain the growth of the global market is provided.
- Region-wise and country-wise market conditions are comprehensively analyzed in this report.
- The projections in this report are made by analyzing the current market trends and future market potential from 2018 to 2025 in terms of value.
- An extensive analysis of various regions provides insights that are expected to allow companies to strategically plan their business moves.
- Key market players within the market are profiled in this report and their strategies are analyzed thoroughly, which helps in understanding competitive outlook of global market.
KEY MARKET SEGMENTS
By Type
- Descriptive Analytics
- Predictive Analytics
- Prescriptive Analytics
By Component
- Software
- Services
By Delivery Mode
- On-premise
- On-demand
By Application
- Insurance claims review
- Payment integrity
- Other applications
By End Users
- Private insurance payers
- Public/government agencies
- Employers
- Third party service providers
By Region
- North America
- U.S.
- Canada
- Mexico
- Europe
- Germany
- France
- UK
- Italy
- Rest of Europe
- Asia-Pacific
- Australia
- Japan
- India
- China
- Rest of Asia-Pacific
- LAMEA
- Brazil
- Saudi Arabia
- South Africa
- Rest of LAMEA
We offer our clients exhaustive research and analysis based on wide variety of factual inputs, which largely include interviews with industry participants, reliable statistics and regional intelligence. Our in-house industry experts play instrumental role in designing analytic tools and models, tailored to the requirements of particular industry segment. These analytical tools and models sanitize the data & statistics and enhance the accuracy of our recommendations and advice. With AMR’s calibrated research process and 360` degree data-evaluation methodology, our clients are assured of receiving:
- Consistent, valuable, robust and actionable data & analysis that can easily be referenced for strategic business planning
- Technologically sophisticated and reliable insights through well audited and veracious research methodology
- Sovereign research proceeds that present a tangible depiction of marketplace
With a strong methodology we are, therefore, confident that our research and analysis are most reliable and guarantees sound business planning.
Secondary research
We refer a broad array of industry sources for our secondary, which typically include; however, not limited to: Company SEC filings, annual reports, company websites, broker & financial reports and investor presentations for competitive scenario and shape of the industry
- Patent and regulatory databases for understanding of technical & legal developments
- Scientific and technical writings for product information and related preemptions
- Regional government and statistical databases for macro analysis
- Authentic new articles, web-casts and other related releases for market evaluation
- Internal and external proprietary databases, key market indicators and relevant press releases for market estimates and forecast
Primary research
Our primary research efforts include reaching out participants through mail, tele-conversations, referrals, professional networks and face-to-face interactions. We are also in professional corporate relations with various companies that allow us greater flexibility for reaching out industry participants and commentators for interviews and discussions, fulfilling following functions:
- Validates and improves the data quality and strengthens research proceeds
- Further develops analyst team’s market understanding and expertise
- Supplies authentic information about market size, share, growth and forecasts
Our primary research interview and discussion panels are typically composed of most experienced industry members. These participants include; however, not limited to:
- Chief executives and VPs of leading corporations specific to industry
- Product and sales managers or country heads; channel partners and top level distributors; banking, investments and valuation experts Key opinion leaders (KOLs)
Analyst tools and models
AMR has developed set of analyst tools and data models to supplement and expedite the analysis process. Corresponding to markets, where there is significant lack of information and estimates, AMR’s team of experts and analyst develop specific analyst tools and industry models to translate qualitative and quantitative industry indicators into exact industry estimates. These models also allow analysts to examine the prospects and opportunities prevailing in the market to accurately forecast the course of the market.
REQUEST TOC/SAMPLE
Purchase Full Report of
Medical Fraud Detection Management Market
- Online Only
-
$3,456$3,110 - Online cloud access only
- Restricted print, copy, paste & download
- Read only
- Free quarterly industry update
- Free report update (Within 180 days)
- Subscription model sign in
- Data Pack
-
$3,840$3,456 - Restricted to one authorized user
- One print only
- Available in Excel
- Free quarterly industry update
- Free report update (Within 180 days)
- Subscription model sign in
- Single User
-
$5,370$4,833 - Restricted to one authorized user
- One print only
- Available in Excel & PDF
- Free quarterly industry update
- Free report update (Within 180 days)
- Subscription model sign in
- Five Users
-
$6,450$5,805 - Limited to five authorized users
- Print upto five copies
- Available in Excel & PDF
- Free quarterly industry update
- Free report update (Within 180 days)
- Subscription model sign in
-
Enterprise
License/PDF -
$8,995$8,096 - Unlimited within company/enterprise
- Available in Excel & PDF
- Free quarterly industry update
- Free report update (Within 180 days)
- Subscription model sign in
*Taxes/Fees, if applicable will be added during checkout. All prices in USD
Why Allied Market Research?
Infallible Methodology
To ensure high-level data integrity, accurate analysis, and impeccable forecasts
Analyst Support
For complete satisfaction
Customization
On-demand customization of scope of the report to exactly meet your needs
TARGETED MARKET VIEW
Targeted market view to provide pertinent information and save time of readers
Get fresh content delivered
Get insights on topics that are crucial for your business. Stay abreast of your interest areas.
Buy Full Version
"Medical Fraud Detection Management Market"
Purchase Enquiry