- FraudScope, an AI-based platform that helps health plans address the increasing problem of fraud, waste, and abuse, announced that it raised $7 million
FraudScope — a fast-growing AI-based platform that helps health plans address the increasing problem of fraud, waste, and abuse — announced it has raised $7 million in Series A funding. The largest participants in the round were QED Investors, Brewer Lane Ventures, and the GRA Venture Fund.
The funding will be used for scaling the team and expanding product offerings to meet the growing needs and opportunities at health plans.
The National Health Care Anti-Fraud Association and other government and law enforcement groups place the cost of healthcare fraud at 3% to 10% of the total healthcare costs in the U.S. or as much as $300 billion. And FraudScope provides health plans with advanced identification and workflow tools to detect and investigate emerging fraud, waste, and abuse schemes, and prioritize claims for greatly reducing their financial risk. These capabilities become extremely valuable to health plans, especially during the COVID-19 pandemic due to the increase in new fraud, waste, and abuse.
This announcement follows a host of other news coming from FraudScope in recent months. And in the first quarter, FraudScope announced its artificial intelligence platform had helped health plan customers realize tens of millions of dollars in fraud, waste, and abuse identifications and savings. Plus FraudScope also recently announced that it achieved Certified status for information security by HITRUST and the company rolled out a series of upgrades and enhancements for its proprietary case management and reporting technology.
Key Quotes:
“Our artificial intelligence-driven innovations in fraud, waste, and abuse identification and prevention are matched only by the results we deliver to our customers. With this round of financing, we are closer to realizing our vision of becoming the AI-based collaboration platform that integrates across fraud, payment integrity, clinical, and provider network teams to drive down costs and increase efficiencies for health plans.” Traditional rules-based techniques to address healthcare fraud, waste and abuse are reactive and cannot identify new and emerging schemes in a timely manner leading to significant financial losses at health plans. FraudScope’s solutions are designed to proactively monitor and identify new schemes as soon as they emerge which helps maximize savings.
– Musheer Ahmed, CEO of FraudScope
“QED is singularly focused on supporting companies that solve real-world problems and can have a broad societal impact. The rising cost of health care is a perfect example of an issue that hurts consumers, businesses, and the economy as a whole – and one that technology is uniquely positioned to help solve. We look forward to using our operational expertise to help the FraudScope team use its cutting-edge machine learning to reduce healthcare fraud, shoring up health plans and bringing down costs for consumers and employers at a time when both are under tremendous pressure.”
– Matt Risley, Partner at QED Investors
“Fraudscope is a leader in AI driven health fraud detection. We are delighted to leverage our operating experience in the insurance industry to assist the company with its strategy and marketing efforts.” This Series A Round brings FraudScope’s total funding to $10.5 million. Existing investors that also participated in the round include Spider Capital, Mosley Ventures, and TechSquare Labs.
– John Kim, Founder and Managing Partner of Brewer Lane Ventures
“As an early investor, the GRA Venture Fund is pleased to see the continued growth of FraudScope’s technology and customer satisfaction. Fraud, waste, and abuse are affecting the whole healthcare system, and we believe that FraudScope’s AI is a strong market differentiator. ”
-Kurt Jacobus, Managing Director of the GRA Venture Fund
