IBM Helps North Carolina Fight Medicaid Fraud
From 5500019Y4B 5500019Y4B on September 19th, 2018
In 2010, Governor Purdue of North Carolina, announced a program to run Medicaid claims through IBM software that can spot suspicious activity and fraud among the nearly two million Medicaid patients and 60,000 Medicaid providers in the state. North Carolina is using IBM analytics which are capable of sorting through tens of thousands of providers and hundreds of millions of claims in minutes using analytics software and then prioritizing those cases with potential abusive behavior. As part of their work with IBM, North Carolina has already identified nearly $200 million in suspicious claims from the initial 250 providers they targeted.