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Whitepaper: Health Insurance Claims Fraud Detection

WEBSeptember 6, 2020. Fraud Detection & Prevention, Insurance, Whitepapers. Insurance companies and providers of health care benefits lose hundreds of millions of dollars …

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URL: https://alessa.com/whitepapers/health-insurance-claims-fraud-detection/

Batling Health Insurance Claims Fraud

WEBInsurance companies and providers of health care beneits lose hundreds of millions of dollars yearly due to fraudulent claims for health beneits.

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COVID-19 Medical Supply Scams

WEBView guidances for dealing with recent medical supply scams, as a result of COVID-19, from FinCEN, and explained by the compliance experts at Alessa.

Category: Medical Go Health

Vendor Due Diligence: What Is It and Why Does It Matter

WEBVendor due diligence (VDD) is a systematic process of evidence-gathering and assessment that helps businesses evaluate potential partners and acquisition …

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What Is the SDN List

WEBSeptember 5, 2023. AML Compliance, Blog. The Specially Designated Nationals and Blocked Persons List (SDN) is a record of individuals, groups, and entities considered to …

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Insurance Claims Data Analytics for Fraud Prevention

WEBAlessa employs a combination of business rules and predictive analytics to detect and prevent fraud throughout the claims process, spanning multiple lines of …

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FinCEN: Latest News, Guidance and Advisories

WEBOct. 15, 2020 – Identifying Human Trafficking. FinCEN has issued an advisory to help financial institutions identify and report human trafficking. The advisory …

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Sagicor Financial: Alessa for Health Insurance Claims Monitoring

WEBSagicor Financial: Alessa for Health Insurance Claims Monitoring. Sagicor Financial Corporation is one of the oldest insurance groups in the Americas and is …

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ACH Fraud: An Overview and Best Practices for Prevention

WEBIn 2022, U.S. account holders transacted 30 billion ACH payments worth over $76 trillion. Unfortunately, ACH payments are increasingly used for fraud. The system is …

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COVID-19 Fraud Scams: Tips for AML Compliance

WEBRead about tips for AML compliance during covid-19, as new fraud and scams emerged, explained by the software solution providers at Alessa.

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Regulatory Reporting Requirements for AML Compliance

WEBAlessa covers all anti-money laundering requirements in a single platform, including Know Your Customer, sanctions list screening, transaction monitoring and …

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Whitepapers Archives

WEBSanction and Watchlist Screening and Filtering: Best Practices. This white paper looks at how to monitor and screen individuals, entities and transactions as well as best practices …

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Customer Due Diligence: Meeting Regulatory Expectations

WEBCustomer due diligence (CDD) is a fundamental component of an effective AML compliance program. It involves the collection of relevant customer information, …

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Customer Risk Factors: Score, Behavior, Activities and More

WEBThe customer risk score is comprised of three categories of risk: customer characteristics; products, services, activities and behaviors; and geographic risk. Once …

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Success Story: Vendor Fraud at Queensland Health

WEBQueensland Health needed to address deficiencies in its budgetary controls after one of its staff members exploited the holes to the tune of nearly $17 million over …

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Compliance Analytics

WEBA rules-based analytic may flag dependents classified as spouses that are outside an age range of 18–75 years old, or children over 25. This seems reasonable and will have …

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Banking Regulatory Compliance Checklist

WEBWhen reviewed frequently, and compared against existing documentation, policies, procedures, and processes, a regulatory compliance checklist can help inform …

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