Global payment processing products and solutions providing company Mastercard enhance Milliman Payment Integrity (MPI) solution using Mastercard’s expertise in artificial intelligence modeling.
MPI solutions will be able to detect suspected healthcare fraud, waste, and abuse more effectively with the help of its newly deployed artificial intelligence model.
Mastercard and Milliman have signed a formal reseller agreement, understanding the importance of this combined solution for their clients.
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Mastercard’s data scientists collaborated with Milliman to develop three artificial intelligence models based on the Milliman Payment Integrity solution’s outputs using its six-step AI model creation process, named AI Express.
According to Milliman, it intended to use modern technologies such as artificial intelligence to find incremental FWA savings for its clients using non-discrete testing methodologies. Therefore Milliman and Mastercard jointly developed this AI model to cater to their needs.
Chief Marketing, Communications Officer, and President of Healthcare at Mastercard, Raja Rajamannar, said, “Leveraging our proprietary technology to build a custom AI model helped them (Milliman) to do just that – provide enhanced fraud detection and operational efficiencies to improve their customers’ experience.”
He further added that the healthcare business could benefit from Mastercard’s solutions designed to make payment systems run more efficiently. According to a report, annual financial losses due to healthcare financial fraud are in billions of dollars.
Moreover, some government agencies also believe that the cost to be as high as 10% of annual health expenditures in the United States, or more than $300 billion. Therefore it becomes necessary to have a tool or solution that can considerably reduce these ever-increasing numbers.
David Cusick from Milliman said, “Our proof-of-concept with Mastercard shows there is a very compelling value proposition when coupling our existing technology solution with Mastercard’s advanced AI and machine learning capabilities.”
He also mentioned that Milliman Payment Integrity is pleased about the expanded fraud, waste, and abuse detection capabilities that the Mastercard FWA AI model now allows them to provide to their clients.