CHIROPTERA is a system designed to support auditing activities at health insurance companies. For the needs of more efficient data processing, it transforms data from reported benefits from healthcare providers and other sources into the context of the insured. This facilitates the monitoring and checking of the data required to make decisions about the delivery, need and quality of healthcare. It uses BigData technology for data processing. Chiroptera is a Fraud Detection System that performs checks on healthcare that has already been paid for, i.e. on closed invoices.
Key Functionality
Imports data from the insurance information system
Automatic processing and transformation of received data using BigData
Massive parallel data processing
Storage of inspection results for medical examiners for further use
Clear display of healthcare provided in the context of the insured person
Key Benefits
Improving the quality of post-revision activities
Financial savings on healthcare costs
Fraud Detection System – detection of healthcare provided without justification
Transformation of economic data from benefits to the health context model of the insured person