According to a research report published by Spherical Insights & Consulting, the Global Healthcare Fraud Detection Market Size Expected to Grow from USD 2.25 Billion in 2023 to USD 16.61 Billion by 2033, at a CAGR of 22.13% during the forecast period 2023-2033.

Get a Sample PDF Brochure: https://www.sphericalinsights.com/request-sample/4556

Detecting and preventing healthcare fraud, waste, and abuse at every stage of the claim process helps to reduce needless expenditures. Facilitate efficient data management, it collects data from internal and external sources, such as watch lists, unstructured texts, third parties, and claims systems, and connects with existing payment integrity solutions. Modern statistics, deep learning, machine learning (ML), and text analytics algorithms are just a few of the advanced analytical and artificial intelligence (AI) techniques that it relies on. Furthermore, it also uses a customizable method to facilitate clinical, investigative, and operational evaluations and saves all associated case data. Healthcare fraud detection systems are becoming more and more necessary as more people look for health insurance. Along with the growing prepayment review model in the healthcare industry, this is one of the primary factors propelling the market. However, a significant problem is the complexity and diversity of healthcare fraud schemes, which often evolve in response to detection methods and make it difficult for fraud detection technology to remain current.

Browse key industry insights spread across 245 pages with 110 Market data tables and figures & charts from the report on the Global Healthcare Fraud Detection Market Size, Share, and COVID-19 Impact Analysis, By Type (Descriptive Analytics, Predictive Analytics, and Prescriptive Analytics), By Delivery Model (On-premises, Cloud-based, and Others), By Application (Insurance Claims Review, Pharmacy Billing Issues, Payment Integrity, and Others), By End User (Private Insurance Payers, Public and Government Agencies, Third Party Service Providers, and Others), and By Region (North America, Europe, Asia-Pacific, Latin America, Middle East, and Africa), Analysis and Forecast 2023 – 2033

Buy Now Full Report: https://www.sphericalinsights.com/checkout/4556

The descriptive analytics segment is expected to hold the majority of the market share through the forecast period.

On the basis of the type, the global healthcare fraud detection market is divided into descriptive analytics, predictive analytics, and prescriptive analytics. Among these, the descriptive analytics segment is expected to hold the majority of the market share through the forecast period. This is attributed to the simplicity of the descriptive analytics tools and their straightforward integration with other data sources to produce expressive insights are the reasons behind this. Descriptive analytics is being used to assess more and more clinical decisions and their impact on overall patient outcomes, care quality, and service performance.

The on-premises segment is expected to hold the highest revenue share through the forecast time.

On the basis of the delivery model, the global healthcare fraud detection market is divided into on-premises, cloud-based, and others. Among these, the on-premises segment is expected to hold the highest revenue share through the forecast time. This is attributed to the site’s data being freely accessible to hospitals and other organizations, which has, among other benefits, enhanced data monitoring and record-keeping.

The insurance claims review segment is expected for the largest revenue share throughout the anticipated time frame.

On the basis of applications, the global healthcare fraud detection market is categorized into insurance claims review, pharmacy billing issues, payment integrity, and others. Among these, the insurance claims review segment is expected for the largest revenue share throughout the anticipated time frame. Health insurance is becoming more widely available, which raises the frequency of fraudulent claims. The remainder of the part is made up of the prepayment and post-payment reviews.

The public and government agencies segment is estimated to grow at a rapid CAGR growth throughout the anticipated time frame.

On the basis of end user the global healthcare fraud detection market is categorized into private insurance payers, public and government agencies, third-party service providers, and others. Among these, the public and government agencies segment is estimated to grow at a rapid CAGR growth throughout the anticipated time frame. This is attributed to the higher number of patients in government hospitals and the greater vulnerability of government institutions to fraud due to a lack of highly developed technical infrastructure, especially in developing nations, which are the primary causes of the high percentage.

Inquire Before Buying This Research Report: https://www.sphericalinsights.com/inquiry-before-buying/4556

North America is projected to hold the largest share of the global healthcare fraud detection market over the anticipated period.

North America is projected to hold the largest share of the global healthcare fraud detection market over the anticipated period. The market for fraud detection is defined by stringent regulatory frameworks and the growing number of sophisticated healthcare systems. Legislative laws such as the False Claims Act and the Affordable Care Act have led to a substantial adoption of fraud detection systems in the region.

Europe is anticipated to grow at the rapid CAGR growth of the global healthcare fraud detection market throughout the predicted period. The increasing incidence of chronic illnesses is leading to a wider use of insurance coverage for patient maintenance during hospitalization. Regional market growth is supported by the yearly rise in surgical procedures conducted in Europe countries, which drives the demand for health coverage.

Competitive Analysis:

The report offers the appropriate analysis of the key organizations/companies involved within the global healthcare fraud detection market along with a comparative evaluation primarily based on their product offering, business overviews, geographic presence, enterprise strategies, segment market share, and SWOT analysis. The report also provides an elaborative analysis focusing on the current news and developments of the companies, which includes product development, innovations, joint ventures, partnerships, mergers & acquisitions, strategic alliances, and others. This allows for the evaluation of the overall competition within the market. Major vendors in the global healthcare fraud detection market are IBM Corporation, Wipro Limited, HCL Technologies, Exlservice Holdings Inc., LexisNexis, Verscend Technologies, Mckesson, Conduent, Cotiviti Inc., OSP Labs, SAS Institute, Inc., International Business Machines Corporation, Scioinspire CORP, FAIR ISAAC Corporation, and others.

Key Target Audience

• Market Players
• Investors
• End-users
• Government Authorities
• Consulting and Research Firm
• Venture capitalists
• Value-Added Resellers (VARs)

Key Market Development

• In June 2023,Jack Henry introduced Payrailz Fraud Monitor, an AI-powered, cloud-native component of the Payrailz Digital Payments Platform. As soon as a payment transaction is started, this feature begins to identify fraudulent activities in real-time.
• In February 2022, The Canadian Life and Health Insurance Association (CLHIA) started an industry-wide initiative to pool claims data and leverage state-of-the-art artificial intelligence (AI) tools to enhance the benefits of fraud detection and investigation.

Market Segment

This study forecasts revenue at global, regional, and country levels from 2020 to 2033. Spherical Insights has segmented the global healthcare fraud detection market based on the below-mentioned segments:

Global Healthcare Fraud Detection Market, By Type

• Descriptive Analytics
• Predictive Analytics
• Prescriptive Analytics

Global Healthcare Fraud Detection Market, By Delivery Model

• On-Premises
• Cloud-Based
• Others

Global Healthcare Fraud Detection Market, By Application

• Insurance Claims Review
• Pharmacy Billing Issues
• Payment Integrity
• Others

Global Healthcare Fraud Detection Market, By End User

• Private Insurance Payers
• Public And Government Agencies
• Third Party Service Providers
• Others

Global Healthcare Fraud Detection Market, By Regional 

• North America

• • US
  • Canada
  • Mexico

• Europe

• • Germany
  • UK
  • France
  • Italy
  • Spain
  • Russia
  • Rest of Europe

• Asia Pacific

• • China
  • Japan
  • India
  • South Korea
  • Australia
  • Rest of Asia Pacific

• South America

• • Brazil
  • Argentina
  • Rest of South America

• Middle East & Africa

• • UAE
  • Saudi Arabia
  • Qatar
  • South Africa
  • Rest of the Middle East & Africa

Browse Related Keys:

Global Life Science Products Market Size, Share, and COVID-19 Impact Analysis, By Product Type (Reagents, Instruments, Consumables and Services), By Application (Drug Discovery & Development, Basic Research, Applied Research and Others), and By Region (North America, Europe, Asia-Pacific, Latin America, Middle East, and Africa), Analysis and Forecast 2025 – 2035

Global E. coli Testing Market Size, Share, and COVID-19 Impact Analysis, By Product (Instruments and Consumables), By Test Type (Clinical Test and Environmental Test), By End-User (Diagnostic Laboratories, Hospitals, Clinics, and Others), and By Region (North America, Europe, Asia-Pacific, Latin America, Middle East, and Africa), Analysis and Forecast 2023 – 2033

Global Virtual Clinical Trials Market Size, Share, and COVID-19 Impact Analysis, By Study Design (Interventional, Observational, and Expanded Access), By Indication (Oncology and Cardiovascular Disease), and By Region (North America, Europe, Asia-Pacific, Latin America, Middle East, and Africa), Analysis and Forecast 2023 – 2033

Global Anti-aging Supplements Market Size, Share, and COVID-19 Impact Analysis, By Ingredient (Collagen, Resveratrol, Vitamins, Minerals, Hyaluronic Acid, NMN, Others), By Application (Hair, Skin, and Nail Care, Bone and Joint Health, Energy and Stamina, Others), By Distribution Channel (Offline and Online), and By Region (North America, Europe, Asia-Pacific, Latin America, Middle East, and Africa), Analysis and Forecast 2023 – 2033

About the Spherical Insights & Consulting

Spherical Insights & Consulting is a market research and consulting firm which provides actionable market research study, quantitative forecasting and trends analysis provides forward-looking insight especially designed for decision makers and aids ROI.

Which is catering to different industry such as financial sectors, industrial sectors, government organizations, universities, non-profits and corporations. The company’s mission is to work with businesses to achieve business objectives and maintain strategic improvements.

CONTACT US:

For More Information on Your Target Market, Please Contact Us Below:    

Phone: +1 303 800 4326 (the U.S.)

Phone: +91 90289 24100 (APAC)

Email: inquiry@sphericalinsights.com, sales@sphericalinsights.com

Contact Us: https://www.sphericalinsights.com/contact-us

Follow Us: LinkedIn | Facebook | Twitter