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Health plan
Fraud, Waste & Abuse Detection Agent
Flags anomalous billing patterns across your provider network and packages the evidence for SIU review.
<div class="hx-demo-box" style="margin-top:40px;border:1px solid #D2D2CA;border-radius:12px;overflow:hidden;background:#fff;box-shadow:0 12px 32px -12px rgba(23,25,21,.18)"><div style="background:#F7F7F3;border-bottom:1px solid #D2D2CA;padding:10px 20px;display:flex;align-items:center;gap:10px"><span style="width:11px;height:11px;border-radius:50%;background:#E4E4DE"></span><span style="width:11px;height:11px;border-radius:50%;background:#E4E4DE"></span><span style="width:11px;height:11px;border-radius:50%;background:#E4E4DE"></span><span style="font-size:12px;color:#8B9086;margin-left:6px">siu.local/providers/PT-network</span></div><div style="padding:20px 22px 4px"><div style="font-size:11px;letter-spacing:0.06em;text-transform:uppercase;color:#585D54;margin-bottom:14px;font-weight:600">CPT 97110 monthly volume, PT network</div><div style="display:flex;flex-direction:column;gap:12px"><div style="display:flex;align-items:center;gap:12px;animation:fadeUp .3s ease both"><span style="flex:0 0 70px;font-size:12px;color:#585D54">#11840</span><div style="flex:1;height:20px;background:#F3F4F0;border-radius:4px;overflow:hidden"><div style="height:100%;width:24%;background:#D2D2CA;border-radius:4px"></div></div><span style="flex:0 0 60px;font-size:12px;text-align:right">412/mo</span></div><sc-if value="{{ r2 }}"><div style="display:flex;align-items:center;gap:12px;animation:fadeUp .3s ease both"><span style="flex:0 0 70px;font-size:12px;color:#585D54">#11841</span><div style="flex:1;height:20px;background:#F3F4F0;border-radius:4px;overflow:hidden"><div style="height:100%;width:22%;background:#D2D2CA;border-radius:4px"></div></div><span style="flex:0 0 60px;font-size:12px;text-align:right">380/mo</span></div></sc-if><sc-if value="{{ r3 }}"><div style="display:flex;align-items:center;gap:12px;animation:fadeUp .3s ease both"><span style="flex:0 0 70px;font-size:12px;font-weight:700">#11842</span><div style="flex:1;height:20px;background:#F3F4F0;border-radius:4px;overflow:hidden"><div style="height:100%;width:100%;background:#E0554F;border-radius:4px"></div></div><span style="flex:0 0 60px;font-size:12px;text-align:right;font-weight:700;color:#8A2E29">1,680/mo</span></div></sc-if></div></div><sc-if value="{{ isDone }}"><div style="margin:16px 22px 20px;padding:14px 16px;border-radius:8px;background:#FCEFED;font-size:13px;color:#8A2E29;animation:pop .4s ease both">⚠ Provider #11842 bills 3.4x the peer average, with same-day billing on 98% of visits and no supporting notes on file. Estimated exposure $184,000. Routed to SIU queue.</div></sc-if></div>
window.HX_DEMOS=window.HX_DEMOS||{};
window.HX_DEMOS["fwa"]=function(Base){
const CYCLE_SEC=8;
class Comp_fwa extends Base {
state={t:0,name:'',email:'',org:'',formSubmitted:false};
componentDidMount(){
this._start=Date.now();
this._iv=setInterval(()=>{
if((Date.now()-this._start)/1000>=CYCLE_SEC){clearInterval(this._iv);return;}
const t=((Date.now()-this._start)/1000)%CYCLE_SEC;
this.setState({t});
},150);
}
componentWillUnmount(){clearInterval(this._iv);}
onName=(e)=>this.setState({name:e.currentTarget.value});
onEmail=(e)=>this.setState({email:e.currentTarget.value});
onOrg=(e)=>this.setState({org:e.currentTarget.value});
submit=()=>this.setState({formSubmitted:true});
renderVals(){
const t=this.state.t;
return {r2:t>=0.8,r3:t>=1.8,isDone:t>=3,
name:this.state.name,onName:this.onName,email:this.state.email,onEmail:this.onEmail,org:this.state.org,onOrg:this.onOrg,submit:this.submit,
formOpen:!this.state.formSubmitted,formSubmitted:this.state.formSubmitted,nameSuffix:this.state.name?', '+this.state.name.split(' ')[0]:''};
}
}
return Comp_fwa;
};
Scan your own network →
Free to start. No credit card.
How the Fraud, Waste & Abuse Detection Agent works
1
Ingests claims data
Ingests claims data
Pulls billing patterns across providers and time.
2
Detects anomalies
Detects anomalies
Flags outlier billing patterns compared to peer providers and historical baselines.
3
Ranks by risk
Ranks by risk
Prioritizes flagged providers by dollar exposure and pattern severity.
4
Step label
Routes to SIU
Packages the evidence for investigator review.
5
Step label
$184K
average flagged exposure per case
3.4x
peer average, the threshold that triggers a flag
60%
faster SIU investigation cycles
See what's hiding in your billing data.
Start free, we'll scan a sample of your real claims data and show you the flags.
✓
Benchmarked against your own provider network, not a national average
✓
Every flag comes with a dollar exposure estimate
✓
Free scan on your first 90 days of claims
Starts free
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