Naviquis

AI-Enhanced Coding Manipulation AI vs. AI: The New Battleground in Healthcare Payment Integrity As providers increasingly adopt AI-assisted medical coding tools, we're witnessing a concerning trend: sophisticated manipulation of these systems to maximize reimbursement. Our detection systems have identified: - Algorithmic upcoding that stays just below traditional thresholds - AI-generated documentation designed to justify higher complexity levels - Pattern-based code selection that appears legitimate but maximizes payment At Naviquis, we're fighting fire with fire - using our own advanced AI to detect these subtle manipulations before claims are paid. The result? Millions saved for our clients while maintaining positive provider relationships. ?? www.naviquis.com #ArtificialIntelligence #HealthcareFraud #MedicalCoding #PaymentIntegrity #FraudDetection

HEALTHCARE FRAUD ALERT: Telemedicine Exploitation on the Rise In 2025, we're seeing a concerning trend in healthcare fraud: sophisticated exploitation of telemedicine services. Fraudsters are: - Billing for virtual services never provided - Systematically upcoding routine telehealth consultations - Creating entirely fictitious patient encounters - Coordinating networks of providers who authorize unnecessary services At Naviquis, our AI-powered detection systems can identify these subtle patterns before claims are paid, protecting your organization's financial integrity while supporting legitimate telehealth providers. Don't wait until post-payment recovery becomes necessary. Prevention is always more cost-effective than recovery! Learn how our post-adjudication, pre-pay integrity solution can help: www.naviquis.com #HealthcareFraud #Telemedicine #PaymentIntegrity #FraudPrevention #Healthcare

Our March Newsletter, written by our very own Yoemy Waller, dives into the latest trends shaping the fight against healthcare fraud, waste, and abuse. With new regulations, evolving schemes, and advanced technology playing a role, staying informed is more critical than ever! ?? Don’t miss out! Subscribe to our LinkedIn Newsletter for expert insights, real-world success stories, and the latest in healthcare innovation. #HealthcareFraud #FWA #HealthTech #HealthcareInnovation #Naviquis

Prevent Fraud, Waste & Abuse BEFORE It Costs You! Every year, an estimated $268 billion is lost due to medical fraud, waste, and abuse. Don't let your practice be part of that statistic! ?? Naviquis' Payment Integrity Engine helps you: ? Identify suspicious claims before they impact your bottom line ? Reduce overall costs and prevent audits, penalties, and clawbacks ? Increase client savings, TPA revenues, and provider satisfaction Our post-adjudication, pre-pay integrity solution is designed to detect and prevent common errors and fraudulent activities—providing immediate ROI while safeguarding your revenue. Empower your practice with smarter fraud detection today! Learn more: www.naviquis.com #HealthcareIntegrity #FraudDetection #RevenueProtection #MedicalBilling #Naviquis #PaymentIntegrity

Detect & Prevent Healthcare Fraud in Real-Time! Naviquis' post-adjudication, pre-pay integrity solution is designed to catch errors and fraud before payments are made—reducing costs, boosting savings, and increasing provider satisfaction. ? Immediate ROI ? Increased TPA revenues ? Advanced AI & ML-powered detection With cutting-edge algorithms, expert systems, and AI-driven automation, we help you stay ahead of fraud, waste, and abuse (FWA)—almost in real time! ?? Ready to optimize your payment integrity? Let’s talk! #HealthcareInnovation #AIinHealthcare #PaymentIntegrity #FWA

Our January Newsletter is here! Written by our very own Yoemy Waller. ?? Subscribe to our LinkedIn Newsletter for expert insights, real-world success stories, and the latest in healthcare innovation! #AIInHealthcare #PaymentIntegrity #InnovationMatters #Newsletter #FraudDetection #TPAs #HealthTech #HealthcareInnovation #CostSavings #Compliance #PaymentIntegrity

We hope you’re enjoying a wonderful holiday season filled with joy and relaxation. As we step into 2025, we remain committed to helping you identify suspicious claims BEFORE they impact your bottom line. Let’s continue to fight fraud, waste, and abuse (FWA) together in the year ahead. Here’s to a successful, secure, and prosperous 2025! ???? https://www.naviquis.com/ #HappyNewYear #FWA #Naviquis #FraudPrevention #2025Goals

Tens of billions of dollars are lost each year to healthcare fraud, according to estimates made by the National Health Care Anti-Fraud Association (NHCAA). As a Third-Party Administrator (TPA), you play a crucial role in preventing fraud, waste, and abuse (FWA) in the healthcare industry today. Click through and view the top five ways TPAs can prevent FWA in healthcare! https://lnkd.in/gNQDJUMQ #HealthcareFraud #PreventFWA #TPA #HealthcareSecurity #FraudPrevention #HealthCareIndustry #StopHealthcareFraud #FWA #HealthCareIntegrity #Naviquis

At Naviquis, we’re revolutionizing payment integrity and network engagement for third-party administrators (TPAs) and health plans. Here’s how we help you stay ahead: ?? PAYMENT INTEGRITY PLATFORM Harnessing AI-powered fraud, waste, and abuse (FWA) detection, our platform operates post-adjudication and pre-payment to flag and prevent fraudulent claims before payments are issued. The result? Protected financial integrity, reduced costs, and instant ROI, all while driving client savings, TPA revenue, and provider satisfaction. ?? MEMBER/PROVIDER ENGAGEMENT Communication is key! Our automated, real-time system enhances provider relationships through transparent updates on unpaid claims, credentialing, and licensing. Say goodbye to abrasion and hello to stronger, more engaged networks. Let’s secure your future together. Contact us today to learn more! https://www.naviquis.com/ #Naviquis #PaymentIntegrity #AI #HealthcareSolutions #FraudPrevention #ProviderEngagement #Innovation

Our November Newsletter is here! Written by our very own Yoemy Waller. Want to learn more about how AI is reshaping payment integrity and unlocking new opportunities each month? ?? Subscribe to our LinkedIn Newsletter for expert insights, real-world success stories, and the latest in healthcare innovation! #AIInHealthcare #PaymentIntegrity #InnovationMatters #Newsletter #PredictiveAnalytics #NLP #FraudDetection #TPAs #HealthTech #HealthcareInnovation #CostSavings #Compliance #PaymentIntegrity