FraudScope, an artificial intelligence platform that detects heatlhcare fraud, waste and abuse, completed a $7 million Series A round of funding last week.
With this financing, FraudScope now has $10.5 million in total funding.
QED Investors, Brewer Lane Ventures and the GRA Venture Fund participated in the funding round, with support from existing investors Spider Capital, Mosley Ventures and TechSquare Labs.
WHAT IT DOES
FraudScope provides health systems a workflow tool that can detect and investigate fraud, waste and abuse schemes using AI technology.
Its system was designed to proactively monitor and identify emerging cases before claims are paid to save health systems money, according to the company.
There are three parts of the platform: FraudScope Professional, Facility and Pharma. Each system identifies providers, facilities and members that are involved in fraudulent schemes.
WHAT’S IT FOR
FraudScope plans to use the capital to scale its team and expand product offerings.
The company said that it needs to do so in order to meet the growing needs of health plans to detect fraud, waste and abuse.
The National Health Care Anti-Fraud Association estimates that healthcare fraud costs the nation about $68 billion annually.
During the pandemic, fraud schemes attacking health systems have become more common, according to the NHCAA. A common attack, according to the Department of Health and Human Services, offers fake COVID-19 tests to Medicare beneficiaries in return for personal information.
ON THE RECORD
“Our artificial intelligence-driven innovations in fraud, waste, and abuse identification and prevention are matched only by the results we deliver to our customers,” Musheer Ahmed, the CEO of FraudScope, said in a statement. “With this round of financing, we are closer to realizing our vision of becoming the AI-based collaboration platform that integrates across fraud, payment integrity, clinical and provider network teams to drive down costs and increase efficiencies for health plans.”