Healthcare Fraud Detection Market Offered in New Research Forecasted through 2028

A startling number of healthcare fraud cases using false billings to Medicare and Medicaid are coming to the fore. A large number of these fraudulent activities entailed false bills of services which were never rendered. This situation can definitely be negated with the advent of AI. Advanced AI algorithms can be used in cases of financial fraud, insurance fraud and transaction fraud. Several trials have found that automated fraud detection systems using AI can negate financial losses, reduce auditors’ workloads and help generate greater resources for the patients. Here the machine learning program is fed with two subsets of billing data, one which is a bill generated by the physician and the other, some data of established fraudulent cases.

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Healthcare Fraud Detection Market – Segmentation

The healthcare fraud detection market can be bifurcated on the basis of:




Delivery Model

On-premise delivery models

On-demand delivery models


Predictive analytics

Descriptive analytics

Prescriptive analytics


Insurance claims review

Payment integrity

End User

Private insurance payers

Government agencies



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The healthcare fraud detection market regional analysis covers:

North America (U.S., Canada)

Latin America (Mexico, Brazil)

Western Europe (Germany, Italy, France, U.K., Spain)

Eastern Europe (Poland, Russia)

Asia Pacific (China, India, ASEAN, Australia & New Zealand)


Middle East and Africa (GCC Countries, S. Africa, Northern Africa)

Some of the leading firms operating in healthcare fraud detection market include Optum, Verscend Technologies, Inc., DXC, Northrop Grumman, Fair Isaac Corporation, HCL Technologies Limited, LexisNexis, SAS Institute Inc., Pondera, Conduent, Inc., SCIOInspire, Corp., CGI Group Inc., Wipro Limited, IBM Corporation, McKesson Corporation, and others.

Pertinent aspects this study on the Healthcare Fraud Detection market tries to answer exhaustively are:

• What is the forecast size (revenue/volumes) of the most lucrative regional market?

• What is the share of the dominant product/technology segment in the Healthcare Fraud Detection market?

• What regions are likely to witness sizable investments in research and development funding?

• What are Covid 19 implication on Healthcare Fraud Detection market and learn how businesses can respond, manage and mitigate the risks?

• Which countries will be the next destination for industry leaders in order to tap new revenue streams?

• Which new regulations might cause disruption in industry sentiments in near future?

• Which is the share of the dominant end user?

• Which region is expected to rise at the most dominant growth rate?

• Which technologies will have massive impact of new avenues in the Healthcare Fraud Detection market?

• Which key end-use industry trends are expected to shape the growth prospects of the Healthcare Fraud Detection market?

• What factors will promote new entrants in the Healthcare Fraud Detection market?

• What is the degree of fragmentation in the Healthcare Fraud Detection market, and will it increase in coming years?