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Durable Medical Equipment Fraud

Locate Fraud using passed in data to save money

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Written by Nick Laughton
Updated 2 years ago
Less than a minute read

This prototype app ingests data feeds from EDI or FHIR and detects potential Durable Medical Equipment (DME) fraud events in real time. Anomalies detected in the data feeds trigger investigation processes which are prioritized by the system based on likelihood and severity of the fraud. Data for the application is stored in the Xenese blockchain for immutability and auditability.

DME Fraud App showing event data and tasks

The investigator can open a task to see the details of the anomaly, and explore the related information.

DME Fraud App showing investigation task details

They can access standard policies and procedures to help determine the next steps. If appropriate, they can assign the investigation to another agency.

DME Fraud App showing investigation process diagram

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