AI Agent Shield Litigation Risk Prediction System Active

Telehealth Fraud Analyzer

Implements XGBoost with LLM hybrid approach for fraud pattern detection. Identifies impossible travel patterns, rapid consultation flags, phantom visits, upcoding, and unbundling.

View Core Logic Back to Worker

Parent Worker Shield Litigation Risk Prediction System

Agent ID

telehealth-fraud-analyzer

Portal Nexgile-PaySentry Nexus

Sector Payment Integrity & Medical Bill Review

Status

Operational

Problem Statement

The challenge addressed

Telehealth expansion has enabled new fraud schemes including impossible travel, rapid consultations, phantom visits, and modifier abuse.

Core Logic

How the agent solves it

Implements XGBoost with LLM hybrid approach for fraud pattern detection. Identifies impossible travel patterns, rapid consultation flags, phantom visits, upcoding, and unbundling. Analyzes geographic... Implements XGBoost with LLM hybrid approach for fraud pattern detection. Identifies impossible travel patterns, rapid consultation flags, phantom visits, upcoding, and unbundling. Analyzes geographic spread and timeframes for provider behavior clustering. Calculates composite telehealth risk scores.

System Navigation

Explore related components

Portal

Nexgile-PaySentry Nexus

Digital Worker

Shield Litigation Risk Prediction System

Current Agent

Telehealth Fraud Analyzer

Here