Client

· A Pharmacy Benefits Manager

· There are about 4 billion prescriptions written is US alone every year.

· FBI estimates, potentially, up to about 10% of the transactions can be classified as FWA

Challenge:

· FWA detection

· Current process is manual, can only find known fraud signatures

· Lots of false positives and undetected fraud (fraudsters are always one step ahead)

Action:

· They invested in our Jumpstart Program.

· We got several years of transaction data in our lab. Our data scientists went to work

· We developed serval supervised and unsupervised learning algorithms to identify FWA

· Only 16 weeks, from start to finish

Outcome:

· Potential for elimination of manual work with full automation

· 80% reduction in false positives, ability to find previously undetected fraud