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Highmark Identifies Millions In New Active Cases With AI-Powered Provider Analysis From Codoxo

posted by Codoxo

on April 5, 2021

BACKGROUND

Kurt Spear, Vice President of Financial Investigation and Provider Review (FIPR) at Highmark, leads a team of 65 professionals who are responsible for Highmark’s anti fraud, waste and abuse (FWA) and post-pay payment integrity programs. Kurt’s team is dedicated to protecting Highmark’s customers and lowering the cost of healthcare by deploying comprehensive solutions that combat FWA. This pursuit of excellence led the FIPR team at Highmark to become one of the earliest adopters of advanced artificial intelligence solutions for post pay provider analysis.

This case study represents the views of the author, not America’s Health Insurance Plans (AHIP). The publication, distribution or posting of this case study by AHIP does not constitute a guaranty of any product or service by AHIP.

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