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Predictive Analytics Or Modeling

Predictive Analytics (PA) or Modeling

Definition

The discipline that analyzes current and historical facts to make predictions about future events. It is a much deeper dive than traditional reports. And PA involves more than just claims data as it also seeks information from as many divergent sources affecting claims as possible. In reviewing claims leakage, PA will focus on areas such as fraud detection: either missed through inadequate investigation or identification of actual fraud (i.e., revealing a coterie of law firms, chiropractors, auto body shops, and professional claimants working together).

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