Health Insurance & FinTech Operations & Health

Predictive Analytics for Health Insurance Fraud & Claims Pre-authorization

H2O.aiREST APIsML ClassificationSecure Diagnostics

The Challenge

Insurance providers suffered heavy financial losses from fraudulent health claims and experienced bottlenecks in manual pre-authorization claim approvals.

Our Solution

Architected an automated fraud detection engine using H2O.ai classification algorithms and secure REST APIs to evaluate incoming claim patterns in real time.

Business Impact

$2.4MFraudulent Claims Intercepted
80%Auto-Approval for Valid Claims
Sub-secondScoring Latency

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