White Paper
Proactive Fraud Prevention in Medicare and Medicaid Using Explainable AI
Healthcare systems continuously lose billions of dollars annually to sophisticated fraud, waste, and abuse schemes that easily bypass outdated, reactive manual defenses. Persistent Systems software revolutionizes this battle by integrating advanced explainable artificial intelligence and machine learning into a proactive prevention framework. This sophisticated platform moves beyond traditional detection delays, automatically identifying suspicious billing patterns and suspicious anomalies in real time. By leveraging transparent machine learning models, investigators gain crystal-clear rationale for every flagged claim, ensuring regulatory compliance and reducing false positives. Ultimately, Persistent empowers healthcare agencies to safeguard critical financial resources, eliminate operat
