Health Care Fraud Detection And Investigation Software Market size was valued at $1.1 billion in 2021, and is projected to reach $3.6 billion by 2031, growing at a CAGR of 12.6% from 2022 to 2031.
Account audits, medical claim auditing, and healthcare fund auditing are all steps in the discovery of healthcare fraud. In the healthcare industry, there are more instances of medical fraud, including situations involving healthcare funding, claims, and insurance. Additionally, the market for detecting healthcare fraud really aids in reducing waste, fraud, and abuse in the industry. Healthcare fraud is the deliberate distortion of facts by patients or healthcare personnel that results in unlawful payments or benefits. Examples of healthcare fraud include the falsification of data by doctors, the filing of numerous claims by different providers for the same patients, the submission of claims for services that have not been rendered, and the misrepresentation of dates for various treatments, frequency, duration, or service descriptions.
Market Dynamics
Drivers
Increasing the Patient Pool’s Use of Health Insurance Will Help the Market
Some of the main growth drivers in the global market are the expanding patient pool choosing health insurance, the worrisome increase in fraudulent occurrences in the healthcare sector, and the increasing push to track abuse and fraud in healthcare.
Increasing use of cloud-based analytical solutions, the rise in the number of healthcare BPOs, the introduction of state-of-the-art fraud identity management software, and social media’s considerable impact on the healthcare sector are a few other optimistic trends. The rapidly expanding use of artificial intelligence (AI) in healthcare products and services may also benefit the global market for healthcare fraud detection.
Opportunities
Developing nations will present appealing opportunities
In the upcoming years, government-supported measures to support the healthcare IT sector may present a lucrative potential for companies that detect medical fraud. During the evaluation period, the leading suppliers will have a variety of growth opportunities due to the spike in financing for the installation of many IT platforms in the healthcare sector.
Restraints
Developing nations’ low awareness levels are a constraint
In the near future, slower market growth is anticipated due to emerging nations’ lower knowledge of healthcare fraud analytics solutions.
Global Health Care Fraud Detection and Investigation Software Market: Major Players
SAS
Fujitsu
Sift
MISP
FraudLabs Pro
OSP Labs
Cofense PhishMe
WhiteHatAI
Pipl
BAM + Fraud
HMS
MinFraud
DataWalk
Global Health Care Fraud Detection and Investigation Software Market: By Types
On-premise
Cloud
Global Health Care Fraud Detection and Investigation Software Market: By Applications
Insurance Claim
Payment Integrity
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Frequently Asked Questions (FAQ) :
- What will be the value of the Healthcare Fraud Detection Market over the forecast period?
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