Customer Story

Identify and Prevent Fraud

Fraud detection is usually manual and labor-intensive. At scale, it can be a tricky problem to tackle. Learn how RapidMiner helped this organization apply AI to identify $20M of fraud.

The Challenge

• Healthcare fraud can be challenging to detect
  • Even for intelligent medical providers & patients
  • Fraudsters well versed in remaining undetected
• Using a manual process to catch fraud wasn’t working
  • Random samples selected for inspection
  • Less than 5% of all transactions were inspected
  • Time-consuming & limited resources

The Solution

• Focused on specific behavioral patterns
• Easily prototyped & tested effectiveness of ML
• Supervised learning deployed:
  • Scan and flag high-risk fraud cases
  • In high volume, in real-time
• Integrated a variety of new sources:
  • Detection of fraud networks 
  • Contextual clues that surround fraudulent acts

The Impact

• $20M Fraud identified
• New end-to-end detection & prevention process
• Able to identify and prioritize high-risk cases
  • Reduced time wasted with random inspections
  • Detect new fraud patterns
• New categories of fraud discovered

Get started with your fraud detection project today!

Request a Demo

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