Combatting fraud in healthcare and government

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Fraud Dollars Identified

$632,305,000

Industries

Federal Government

Federal Government

Detect and prevent fraud, waste, and abuse by identifying problem areas and patterns.

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Healthcare

Healthcare

Analyze providers, eligibility, pharmacies, members, claims, and encounters for suspicious activities.

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Social Services

Social Services

Validate identities, verify eligibility, and identify emerging fraud schemes.

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Solutions

Data Fitness

Data Fitness

Analyze the fitness of your data for fraud detection analysis and compliance. Codebooks alert you to problems with source data files that may lead to inaccurate analytics and challenges with federal reporting compliance.

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Fraud Detection

Fraud Detection

Program data and 3rd party data are ingested and run through procedural and prediction models to detect previously known and unknown bad actors, schemes, and patterns. Data is vetted prior to analysis with our proprietary data profiler tool and assessed for completeness, efficacy, consistency, and usefulness.

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Case Management

Case Management

Fully-integrated investigative case management imports cases from the fraud detection module or other sources and uses workflow and rules engines to route cases through your resolution process. The mobile application allows field investigators to review, record, and track cases while in the field.

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Testimonial

“We deal with fraud in about 40 ways…but the Pondera solution is the most technologically advanced system that we’ve seen.”

Patrick Henning Jr.

Former Director, CA EDD

  • Rampant Greed at Any Cost

    By Jon Coss, CEO

    February 19, 2020
    In a particularly disturbing drug fraud scheme, John Kapoor, the billionaire founder of Insys Therapeutics, was sentenced last month to…
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  • Beauty Queen Fraudster

    By Jon Coss, CEO

    February 11, 2020
    A recent high-profile fraud case may help highlight a particularly disturbing form of fraud that we often write about on…
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  • Hoverboard Dentist Update

    By Jon Coss, CEO

    February 3, 2020
    Way back in October of 2017, I wrote a blogpost about an Anchorage dentist who was defrauding Medicaid by performing…
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