healthcare fraud detection market

Healthcare Fraud Detection Market By type (Predictive Analytics, Descriptive Analytics, Prescriptive Analytics), By application (Insurance claims review, Payment integrity), By delivery model (On-premise, On-demand), By component (Services, Software), By end user (Employers, Private insurance payers, Third party service providers, Public/government agencies), Industry Trends, Estimation & Forecast, 2017 2025

  • Published Date: 2020-11-27
  • Report ID: 22779
  • Pages: 150
  • Format: prudent report format

The research report offers a comprehensive picture of the Healthcare Fraud Detection market. The report initiates with the executive summary of the market that includes market definition, recent industry trends, and developments, strategies of the key players and wide product offerings. Moreover, the study explains the future opportunities and a sketch of the key participants actively operating in the market.

About Healthcare Fraud Detection Market

Healthcare fraud refers to the fraud of health insurance, drug, and medical practices which involves defrauding insurance company or healthcare plans of government. Data mining is the technique adopted by the leading companies to overcome these fraudulent activities, which requires the knowledge of healthcare systems, frauds, and analysis of healthcare insurance data. Moreover, increasing number of healthcare BPO and growing implementation of fraud identity management are also driving the growth of the healthcare fraud detection market. However, lack of skilled employees in this industry and disinclination towards the adoption of healthcare fraud analytics in developing countries, are the main determinants hindering the growth of healthcare fraud detection market.

The research report is prepared based on the combination of qualitative as well as quantitative aspects. By thorough understanding, the report is fragmented by larger ratios. The report covers in-depth analysis with major factors such as drivers, restraints, opportunities, and challenges that influences the growth of the market. On the other hand, The Healthcare Fraud Detection report presents data starting from the base year 2018, historical year: 2014-2018, estimated the year 2019 and Forecast year from 2019 to 2026.

The Healthcare Fraud Detection market report offers the market size and estimates the forecast from 2019-2026. The forecast estimation is predicted based on the key regions that include North America, Europe, Asia Pacific, Middle East, South America, and the Middle East & Africa. Furthermore, the Healthcare Fraud Detection report provides a deep emphasis on secondary tools used to document the report. PEST analysis, SWOT, Porters Five Forces, and others are considered by the analysts while preparing the report.

Scope and Segmentation of the Market

Based on Type

Predictive Analytics
Descriptive Analytics
Prescriptive Analytics

Based on Application

Insurance claims review
Payment integrity
Others

Each segment of the Healthcare Fraud Detection market is extensively evaluated in the research study. The segment analysis covered in the report aims at the key opportunities available in the Healthcare Fraud Detection market report by leading segments. In addition, the research report offers market dynamics for the market that influences qualitative as well as quantitative research.

Research Methodology

The report follows a comprehensive and rigorous research methodology to provide you accurate estimates and forecasts of a particular market. The report provide estimates, forecast, and analysis primarily based on secondary research, primary interviews, in-house database and other free as well as paid sources. In addition, the research methodology we follow is a systematic approach in order to estimate and project the market sizing keeping in mind all the ongoing and upcoming trends of the market.

Competitive Landscape

Key players profiled in this report include (Sales Revenue, Price, Gross Margin, Main Products, etc.):

Optum
SAS
SCIO
McKesson
Verscend
Conduent
Wipro
HCL
DXC
CGI
LexisNexis
Northrop Grumman
IBM
Pondera

Through the successive chapters on the company, profiles provide deep insights on players operating in the Healthcare Fraud Detection market. It focuses on the financial outlook of the key players, the status of R&D, strategies adopted, expansion strategies, and many more. Analysts preparing the report have offered a detailed list of the strategic initiatives adopted by the Healthcare Fraud Detection market participants by referring past records and designing strategies to be adopted in the coming years. This enables the key players to stay ahead in the competition.

Regional Landscape

The chapter on regional segmentation details the regional aspects of the Healthcare Fraud Detection market. This chapter explains the regulatory framework that is likely to impact the overall market. It highlights the political scenario in the market and anticipates its influence on the Healthcare Fraud Detection market. Moreover, the report focuses on value and volume at the regional level, company level, and level.

Chapters covered under this report include:

Chapter 1, describes the Healthcare Fraud Detection market reports - market overview, executive summary, and market scope. Further, the report adds a support base to identify the information and pick in relation to the aforementioned market

Chapter 2, defines the research methodology based on primary as well as secondary research, secondary data sources, and assumptions & exclusions

Chapter 3, description of Healthcare Fraud Detection market in terms of its product scope, opportunities, drivers, restraints, and market risks

Chapter 4, the report offers a company profile of the top manufacturers of Healthcare Fraud Detection market with its sales, revenue, share, and others

Chapter 5 and 6, to narrow down the sales data at the country level with shares, revenue, sand sales from 2018-2026

Chapter 7, the Healthcare Fraud Detection market data is published based on a regional level and to show the revenue, sales, and growth on basis of the base year 2018, historical year: 2014-2018, estimated the year 2019 and Forecast year from 2019 to 2026

Chapter 8, describes the Healthcare Fraud Detection market sales channels, distributors, research findings, appendix, and among others.


CHAPTER 1. INTRODUCTION
1.1. RESEARCH METHODOLOGY
1.1.1. ERC desk research
1.1.2. ERC data synthesis
1.1.3. Data validation and market feedback
1.1.4. ERC data sources

CHAPTER 2. HEALTHCARE FRAUD DETECTION MARKET OVERVIEW
2.1. HEALTHCARE FRAUD DETECTION MARKET INTRODUCTION
2.2. GLOBAL HEALTHCARE FRAUD DETECTION MARKET REVENUE AND GROWTH RATE, 2017-2025
2.2.1. Global Healthcare Fraud Detection Market Revenue (Million USD) and Growth Rate (%), (2017-2025)

CHAPTER 3. GLOBAL HEALTHCARE FRAUD DETECTION MARKET BY TYPE, 2017-2025
3.1. PREDICTIVE ANALYTICS
3.2. DESCRIPTIVE ANALYTICS
3.3. PRESCRIPTIVE ANALYTICS
3.4. GLOBAL HEALTHCARE FRAUD DETECTION MARKET REVENUE BY TYPE, 2017-2025
3.4.1. Global Healthcare Fraud Detection Market Revenue (Million USD) and Share (%) By Type, 2017-2025
3.4.2. Predictive Analytics Market Revenue and Growth Rate, 2017-2025
3.4.3. Descriptive Analytics Market Revenue and Growth Rate, 2017-2025
3.4.4. Prescriptive Analytics Market Revenue and Growth Rate, 2017-2025

Note: Similar information coverage has been provided for delivery model segment.

CHAPTER 4. GLOBAL HEALTHCARE FRAUD DETECTION MARKET BY APPLICATION, 2017-2025
4.1. INSURANCE CLAIMS REVIEW
4.2. PAYMENT INTEGRITY
4.3. OTHERS
4.4. GLOBAL HEALTHCARE FRAUD DETECTION MARKET REVENUE BY APPLICATION, 2017-2025
4.4.1. Global Healthcare Fraud Detection Market Revenue (Million USD) and Share (%) By Application, 2017-2025
4.4.2. Insurance claims review Market Revenue and Growth Rate, 2017-2025
4.4.3. Payment integrity Market Revenue and Growth Rate, 2017-2025
4.4.4. Others Market Revenue and Growth Rate, 2017-2025

Note: Similar information coverage has been provided for component and end-user segment.

CHAPTER 5. GLOBAL HEALTHCARE FRAUD DETECTION MARKET BY REGION, 2017-2025
5.1. NORTH AMERICA
5.1.1. U.S.
5.1.2. Canada
5.1.3. Mexico
5.2. EUROPE
5.2.1. U.K.
5.2.2. France
5.2.3. Germany
5.2.4. Italy
5.2.5. Spain
5.2.6. Rest of Europe
5.3. ASIA PACIFIC
5.3.1. China
5.3.2. Japan
5.3.3. India
5.3.4. Korea
5.3.5. Rest of APAC
5.4. SOUTH AMERICA
5.4.1. Brazil
5.4.2. Rest of South America
5.5. REST OF THE WORLD
5.5.1. Middle East
5.5.2. Africa
5.6. GLOBAL HEALTHCARE FRAUD DETECTION MARKET REVENUE BY REGION, 2017-2025
5.6.1. Global Healthcare Fraud Detection Market Revenue (Million USD) and Share (%) By Region, 2017-2025
5.6.2. North America Market Revenue and Growth Rate, 2017-2025
5.6.3. Europe Market Revenue and Growth Rate, 2017-2025
5.6.4. Asia Pacific Market Revenue and Growth Rate, 2017-2025
5.6.5. South America Market Revenue and Growth Rate, 2017-2025
5.6.6. Rest of the World Market Revenue and Growth Rate, 2017-2025

CHAPTER 6. MARKET DETERMINANTS
6.1. MARKET DRIVERS
6.2. MARKET RESTRAINTS
6.3. MARKET OPPORTUNITIES
6.4. MARKET DETERMINANTS RADAR CHART

CHAPTER 7. GLOBAL HEALTHCARE FRAUD DETECTION MARKET COMPETITION BY SERVICE PROVIDERS
7.1. GLOBAL HEALTHCARE FRAUD DETECTION REVENUE AND SHARE BY SERVICE PROVIDERS (2017-2025)
7.1.1. Global Healthcare Fraud Detection Revenue (Million USD) and Share (%) by Service Providers (2017-2025)
7.2. HEALTHCARE FRAUD DETECTION MARKET COMPETITIVE SITUATION AND TRENDS
7.2.1. Healthcare Fraud Detection Market Share (%) of Top 3 Service Providers
7.2.2. Healthcare Fraud Detection Market Share (%) of Top 5 Service Providers

CHAPTER 8. COMPANY PROFILES
8.1. OPTUM
8.1.1. Business Overview
8.1.2. Company Basic Information
8.1.3. Healthcare Fraud Detection Product Details
8.1.4. Optum Healthcare Fraud Detection Revenue and Gross Margin
8.2. SAS
8.2.1. Business Overview
8.2.2. Company Basic Information
8.2.3. Healthcare Fraud Detection Product Details
8.2.4. SAS Healthcare Fraud Detection Revenue and Gross Margin
8.3. SCIO
8.3.1. Business Overview
8.3.2. Company Basic Information
8.3.3. Healthcare Fraud Detection Product Details
8.3.4. SCIO Healthcare Fraud Detection Revenue and Gross Margin
8.4. VERSCEND
8.4.1. Business Overview
8.4.2. Company Basic Information
8.4.3. Healthcare Fraud Detection Product Details
8.4.4. Verscend Healthcare Fraud Detection Revenue and Gross Margin
8.5. HCL
8.5.1. Business Overview
8.5.2. Company Basic Information
8.5.3. Healthcare Fraud Detection Product Details
8.5.4. HCL Healthcare Fraud Detection Revenue and Gross Margin
8.6. DXC
8.6.1. Business Overview
8.6.2. Company Basic Information
8.6.3. Healthcare Fraud Detection Product Details
8.6.4. DXC Healthcare Fraud Detection Revenue and Gross Margin
8.7. LEXISNEXIS
8.7.1. Business Overview
8.7.2. Company Basic Information
8.7.3. Healthcare Fraud Detection Product Details
8.7.4. LexisNexis Healthcare Fraud Detection Revenue and Gross Margin
8.8. IBM
8.8.1. Business Overview
8.8.2. Company Basic Information
8.8.3. Healthcare Fraud Detection Product Details
8.8.4. IBM Healthcare Fraud Detection Revenue and Gross Margin
8.9. NORTHROP GRUMMAN
8.9.1. Business Overview
8.9.2. Company Basic Information
8.9.3. Healthcare Fraud Detection Product Details
8.9.4. Northrop Grumman Healthcare Fraud Detection Revenue and Gross Margin
8.10. PONDERA
8.10.1. Business Overview
8.10.2. Company Basic Information
8.10.3. Healthcare Fraud Detection Product Details
8.10.4. Pondera Healthcare Fraud Detection Revenue and Gross Margin

CHAPTER 9. HEALTHCARE FRAUD DETECTION MARKET VALUE CHAIN ANALYSIS
9.1. HEALTHCARE FRAUD DETECTION INDUSTRIAL CHAIN ANALYSIS
9.2. CONSUMER ANALYSIS
9.2.1. Consumer 1
9.2.2. Consumer 2
9.2.3. Consumer 3
9.2.4. Consumer 4
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