$250B

6-7%

Is the cost each year of global healthcare fraud, waste and abuse.

CGI ProperPay has helped government and commercial payers recover more than $2.8 billion in improper payments.

Is the global average loss rate due to medical claims fraud. These losses drive up the costs of care and take away funds that otherwise could be used to treat patients.

Learn more at cgi.com/properpay© 2017 CGI Group Inc.

Workflow Management• Case Management• Document Management• Reporting

Data Analytics• Outlier Analysis• Anomaly Detection• Predictive Modeling• Machine Learning

Data Management• Payment Data• Bene�ciary Data• Provider Data• Other

Rules Management• Policy• Pricing• Duplicates

Data Extraction

Data Warehouse

Web Access

CGI ProperPay

is a data-driven solution that predicts, identifies, manages and recovers improper payments of medical and pharmacy claims.

CGI ProperPay

Payers can address fraud, waste and abuse before claims are paid; or, after claims are paid to recover payments for

improper claims.

Pre-payment & post-payment

CGI ProperPay identifies patterns to detect improper payment scenarios and review cases.Approaches are refined through predictive modeling and machine learning to reduce false positives using Cortana Intelligence Suite.

including clinicians, nurses and medical billing specialists, can analyze, audit and recover improper claims, providing a depth of analysis only those with medical backgrounds can provide.

Medical experts

Advanced analytics

$2.8B recovered

SaaS in the Secure Azure Cloud (PII, PHI)

Secure, compliant Azure cloud

protects highly sensitive personal health and

personal identity data.SaaS delivery enables rapid

deployment and greater scalability.

CGI ProperPay

Predict Prevent Recover