Monitor, detect, analyze and prevent fraud, waste and abuse.

Overview

The Answers Suite is an integrated arsenal of medical record analysis and fraud detection applications. Armed with quality control mechanisms, intuitive analytics, and interactive reports, Answers gives you the tools to combat fraud, waste, and abuse.

FEATURES

Detection and Monitoring

Supporting Utilization Review

Various team members can simultaneously examine specific datasets related to diagnosis, payment patterns, medical providers, patients, prescriptions, and demographic and peer-to-peer comparisons.

Encourage productivity

Users can review an unlimited number of medical records and claims with greater speed and accuracy. For added efficiency and convenience, Answers comes with the complete set of industry standard procedures and diagnoses codes (CPT and ICD-9 and ICD-10).

Retrieve several years of active files

Answers is customized to work in conjunction with customers’ database and processing systems. Revolutionary storage capabilities uniquely enable customers to electronically retain active medical records and historical data for 7+ years.


Analysis and Reporting

Reinforce effective team work

The Answers report wizard makes it easier for users to compile, save and share reports within fraud units, and across regions. Reports can also be printed or exported to spreadsheets, pdf, and word (doc) formats.

Get a multi-dimensional view of every claim

The system’s interactive reporting system has data mining and drilldown functionality. Users will be amazed at their ability to easily single out one claim out of thousands. Investigators and analysts will find that documentation generated with Answers, will help them focus on problem areas.

Prepare interactive and in-depth reports

Users can quickly build, graph, and share reports with an ad-hoc report type or based on pre-defined parameters. Answers can identify profiles of utilization and costs by provider, facility, diagnoses, procedures, and location, among others.


Data Mining, Modelling and Alerts

Control access to sensitive data

Role based security and password encryption empowers managers and system administrators to control access to program functions and data. Answers is also password encrypted.

Identify emerging risks

Rule and behavior based algorithms with set risk thresholds ensures various data analyses including comparative and trend analyses, *LEIE match assessments, and predictive models routinely run. Discrete alert system triggers red flags as potential risks and significant outliers arise.

Review shifts and data spikes at a glance

The Answers smart dashboard uses current data to display graphic depictions of reports preselected by the user. A toggle option enables users to quickly switch between graph and table view.

Videos

Fraud costs government health care organizations like Medicaid and Medicare millions of dollars each year. Watch Bill O'Leary, Microsoft's Executive Director Policy, Health & Human Services and Ade Adebisi, Ascellon's President as they discuss the current fraud challenges facing government as well as technology solutions to combat fraudulent activity.


Microsoft technology solutions help Public Sector and Social Services organization streamline administration, maximize services, and empower citizens. To learn more about Microsoft’s solutions for government, click here


For the past 15 years, Ascellon has provided professional services and software products to help enhance the quality of various government programs nationwide, including Program Integrity, Grants Monitoring and Management, Medical Records and Claims Reviews, and Long Term Care. Ascellon is a proud member of the Microsoft Partner Network.www.ascellon.com


ANSWERS is a post-payment claims analysis, data mining and medical record review system that helps agencies identify and safeguard against fraud, waste and abuse. ANSWERS is built on a Microsoft Platform. The software suite combines traditional approaches of data mining with improved tools that allow analysts and investigators to quickly react to emerging trends in potential fraudulent behavior. www.ascellon.com/answers

Download Brochure

Pilot Programs are available to learn more about how Microsoft and Ascellon’s can help your organization combat fraud, waste and abuse. Please contact Sandeep Godavarthi at 240-487-3001, or sgodavarthi@ascellon.com.