Cutting Through Complexity:
An AI-Powered Search Tool for Regulatory Compliance

Elder Research developed a data organization and search solution in partnership with the American Health Care Association and the National Center for Assisted Living (AHCA/NCAL), streamlining access to complex regulatory documents.

Improving Workers’ Compensation Provider Fraud Detection

Elder Research automated fraud detection for a national Workers’ Compensation Insurance Program to optimize investigations and forensic analysis

Predicting Propensity to Pay Medical Bills

Elder Research developed predictive models to rank patients based on their propensity to pay medical bills and identify actions to encourage payment.

Disease Event Detection Using Medical Sensor Data

Elder Research provided machine learning models using implanted medical sensor data to identify abnormal activity that are predictive of the disease.

Assessing Second Opinion Effects on Return to Work

Elder Research was tasked to evaluate the effectiveness of second opinions to encourage federal employees on long term disability to go back to work. 

Predicting Parkinson’s Disease

Elder Research developed predictive models for Michael J. Fox Foundation to score tests and biomarkers to find those valuable in predicting Parkinson’s disease.

Machine Learning for Disease Event Detection

Elder Research developed a predictive algorithm to define asthma and identify predictive biomarkers that are a molecular signature for asthma.

Predicting Philanthropic Propensity

Elder Research developed a predictive model that identified 20-30% more patients with a high likelihood of becoming a donor to a health foundation.

Detecting Fraudulent Workers’ Compensation Claims

Department of Labor OIG wanted to detect fraud in Office of Workers’ Compensation Program data. The goals were to highlight abnormalities in the claims data that could be used for future audits and to create visualization tools to allow auditors to easily explore potentially fraudulent claims.

Detecting Healthcare Insurance Fraud, Waste, and Abuse

The goal for this project was to identify and quantify fraud, waste, and abuse indicators for a Medicare and Medicaid Dental Insurance client so that they could rank potentially fraudulent providers and target them for appropriate interventions.

Reducing Contract and Claims Fraud, Waste, and Abuse

Elder Research developed and deployed a custom solution to identify and prioritize questionable contracts and healthcare claims for fraud investigation.

Prioritizing Long-Term Care Claims

Elder Research developed a risk scoring model to optimize management of long-term care claims and identify those most likely to benefit from outreach.

Improving Service Provider Performance and Patient Outcomes

Elder Research developed a provider risk scoring model for a major dental insurance provider that enabled targeted intervention with low quality providers and reduced per patient cost by nearly 25 percent.

Improving Claims Approval Speed and Accuracy

Elder Research combined state-of-the-art text analytics with traditional statistical techniques to create a solution for ranking disability claims for approval. The results were more accurate and consistent than any single doctor’s decision and allowed 20% of the claims to be approved immediately.

Discovering the Efficacy of a New Drug

Pharmacia & Upjohn invited Elder Research to examine the data for a new drug and determine the drug’s viability. The research discovered a real effect, and these decisive results were communicated to decision makers using a novel visualization technique.