The development of intelligent fraud detection models for tracing loopholes in procedures is expected to lead to successful reimbursement of fraudulent medical bills.
Dubai – TachyHealth, a healthcare technology startup that provides intelligent solutions for value-driven healthcare, has partnered with researchers from Zayed University in Abu Dhabi to identify healthcare fraud, waste, and abuse by using Graph Neural Networks (GNNs). The project is funded by a AED 300,000 Research Innovation Fund (RIF) grant and will run for two years.
Titled “Fraud detection in medical claims using Graph Neural Networks”, the project will seek to develop GNN algorithms for fraudulent transactions in healthcare systems; analyse GNN strengths and weaknesses; develop a visual decision support system for deploying algorithms as an end-to-end solution in a real-world environment; eliminate fraud and prevent abuse of medical services; and minimise the workload faced by institutions.
The project team is led by Dr. Dina Tbaishat, Principal Investigator, from Zayed University. She is supported by Drs. Mohd Amril Nurman and Ravishankar Sharma, who are Co-Principal Investigators. Dr. Ahmed Talaat Sahol, Chief AI Officer, and Mustafa AbdulRazek, Machine Learning Engineer join as industrial collaborators from TachyHealth.
Dr. Osama AbouElkhir, CEO of TachyHealth, said: “We are excited to partner with Zayed University on this important project. The number of claims made by beneficiaries has risen rapidly because of fraudulent billing, and detecting fraudulent transactions is difficult owing to various complexities. This project seeks to address healthcare fraud and abuse using AI, which will save money and improve patient care.”
Dr. Mohamed Amril Nazir, Associate Professor, Zayed University, said: “Closer collaboration with the private sector produces research which aligns with national and international agendas, and adds value to businesses and governments. This is a key component of Zayed University’s approach to research. Our new partnership with TachyHealth will see us work together to create a solution which addresses fraud and provides tangible benefits to healthcare professionals and patients, here in the UAE and internationally.”
The project will build on TachyHealth’s existing work in areas such as AiClaim, its solution to detect fraud in medical claims, and is aligned to both the UAE’s innovation strategy and the UAE Artificial Intelligence Office’s vision to use advanced technologies in healthcare.
About TachyHealth
TachyHealth is a Delaware-based healthcare technology company with a presence in four countries: the US, the UAE, KSA, and Jordan. Founded in 2018, the company has developed solutions for re-inventing the interaction between healthcare providers and payers through utilising artificial intelligence and data science, with the aim of eliminating waste, saving money, and improving the patient journey for value-based healthcare. The interconnected intelligent solutions offered include: AiGuide for medical doctors, AiCode for medical coders, AiClaim for claim management, and AiReview for claims review and auditing by the payers.
The startup has seen tremendous growth, especially following the COVID-19 pandemic when the transformation of healthcare became a priority for healthcare systems across the MENA region through enhanced revenue cycle management, medical coding and claims management focusing on outcome and value rather than quantities and activities. This is confirmed by a growing client list that includes Wipro, UEMedical, MedNet, and Nathealth.
Visit www.tachyhealth.com for more information.
