The 41st Parameter, Inc.

Experian Health, Inc.

Passport Health Communications, Inc.

Elazar Katz

Systems and methods for fraud containment are provided in accordance with an embodiment of the invention. A fraud event may be detected. One or more devices that may be used in perpetrating the fraud event may be detected. Additionally one or more potential fraud victims, who may be grouped into victim circles may be detected. The threat level to the victims and/or victim circles may be assessed. In some instances, behavioral profiles may be utilized to make fraud assessments. Based on the threat level, recommendations for fraud containment responses may be provided.

Methods and systems for fraud containment

An identity management method includes comparing person-to-person relationship data of at least two identifiers of individuals to determine if the at least two identifiers have a relationship with a common third party identifier. The person-to-person relationship data is obtained from one or more sources and the at least two identifiers are the same or similar. When it is determined that the at least two identifiers have a relationship with a common third party identifier, the method further includes generating an output indicating that the at least two identifiers actually identify the same individual. The output can alternatively, or further, include a confidence level indicative of the confidence that the at least two identities do indeed identify the same individual. The person-to-person relationship analysis can be combined with other forms of identity matching, e.g., demographics.

Identity management

Systems and methods for improved detection of fraud, waste, and abuse are provided, based on the analysis of enriched relationships and aggregated metrics thereof. An enriched relationship record associates patient and provider information to provide an enhanced view of patient data, provider data, and interaction data for a given entity. Aggregated metrics provide an enhanced view of a particular entity's activities based on the entity's interactions with other entities and data and metadata from the related entities' enriched relationship records. The enriched relationship records and aggregated metrics may be used to audit the entity and produce a report indicative of suspicion levels for the entity engaging in fraud, waste, or abuse.

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Boynton Beach, FL, United States of America

Elazar Katz