IBM Fraud and Abuse Management System on Azure

IBM is a recognized global leader in program integrity and uncovering fraud, waste and abuse. Our methodology combines industry expertise, best practices and mature models that have delivered consistent results for multiple clients for over 25 years. Our solution is deployed for several states, federal clients, and private companies, successfully detecting income tax fraud, benefits fraud, healthcare fraud, internal fraud and travel & expense fraud.

From a technical perspective, our counter-fraud solution includes the Next Generation Entity Profiling System (Next Gen). This containerized, cloud-based solution is capable of historical profiling and real-time detection employing a combination of supervised and unsupervised modeling using both Artificial Intelligence (AI) and Machine Learning (ML). The Event Stream Processing capabilities allow our clients to act on the highest-risk transactions prior to payment.

Next Gen’s AI and ML models are based on Spark’s ML libraries. Our client’s use these powerful algorithms to detect fraud and abuse at the transaction and entity level both with and without historical fraud markings. These models can ingest new transaction and entity information as it becomes available and recalculate a risk score based on this data.

IBM's counter-fraud methodology and solution gives our clients the ability to detect both known and unknown fraud schemes in virtually any industry that has transactions. We offer cloud-based implementations as well as the 'Software-as-a-service' model. Our approach and technology has successfully saved our clients millions.