The vice president of the Healthcare, Cyber & Intelligence at MasterCard Beth Griffin has revealed, during the PYMNTS Masterclass interview, that company’s AI-empowered Fraud Detection System is already helping to reduce the numbers of fraud cases in healthcare claims.
According to Beth Griffin, in the US, around $240 billion of the healthcare system payments are not actually helping patients, but represent fraud, waste, and abuse. With company’s experience in payment processing and the AI company Brigtherion acquisition in 2017, MasterCard has developed an AI system to eliminate healthcare processing system weak points:
“We securely store over 18 petabytes of sensitive data — this is a significant amount of data that we’re dealing with every day. And we detect and defeat over 200 attacks on our network every minute of every day”
MasterCard is not trying “to replace what exists today” but attempts to complement the system with an additional predictive layer, highlighted Griffin. Fraud prevention units in most cases can determine the fraudulent transactions, but mostly it happens after the claim has been paid, and only a fraction of such payments can be returned, that is why real-time predictive power of AI presents a new way to save money.
As Griffin pointed out, since 3-10% of healthcare costs are attributed to some kinds of fraud, the impact of implementing AI system is “worth it”. After all, minimising fraud helps to reduce the general healthcare cost both for providers and payers.
MasterCard is known for their interest in new technologies like AI and blockchain. The company has been one of the members at the Facebook-led Libra Association, before dropping out of the Association over doubts on the viability of Libra’s business model.