The Latin America, Middle East and Africa Healthcare Fraud Analytics Market would witness market growth of 25.4% CAGR during the forecast period (2022-2028).
Medicaid has been one of the most sensitive parts for fraud in recent years. Due to a lack of cross-program communication, a scattered management approach, and a difficult-to-follow patient group of low-income people and their children, this is the case. Effective fraud analytics solutions can assist in lowering these high expenses.
Illegal medical billings including forged claims, multiple claims filed by multiple providers for the same patient, patient identity theft and use for reimbursement, and collusion between unethical clinicians and their patients are just a few examples of prevalent healthcare fraud.
From a patient's zip code to a physician's qualifications, big data has a huge amount of information. To discover fraudulent tendencies, insurers can manually review and compare populations and providers, but contemporary data analysis systems can typically spot fraud automatically. Naturally, the bigger the data set, the more useful it is. Data that presents a complete picture of a situation and contains all elements that may be impacting the data is required for precisely detecting fraud and waste.
The LAMEA region requires the incorporation of healthcare fraud analytics system in every healthcare institutions because now other relevant policies and regulations are not enough to combat the frauds committed by the statutory authorities that are responsible to monitor healthcare frauds as well as impose the fines on the violators. The Investigators of healthcare frauds are observing more and more collusion type frauds that are committed by both combined healthcare professionals and patients. One of the biggest obstructions to the fight against healthcare fraud is the dearth of good legislation along with the incapability to reinvest seized funds in the healthcare systems.
The Brazil market dominated the LAMEA Prescriptive Analytics Market by Country in 2021, and would continue to be a dominant market till 2028; thereby, achieving a market value of $28.6 million by 2028. The Argentina market is estimated to grow at a CAGR of 26.6% during (2022 - 2028). Additionally, The UAE market would experience a CAGR of 25.6% during (2022 - 2028).
Based on Delivery Model, the market is segmented into On-premise and Cloud. Based on Application, the market is segmented into Insurance Claim Review, Pharmacy billing Issue, Payment Integrity, and Others. Based on End User, the market is segmented into Public & Government Agencies, Private Insurance Payers, Third-party Service Providers, and Employers. Based on Solution Type, the market is segmented into Descriptive Analytics, Predictive Analytics, and Prescriptive Analytics. Based on countries, the market is segmented into Brazil, Argentina, UAE, Saudi Arabia, South Africa, Nigeria, and Rest of LAMEA.
Free Valuable Insights: The Global Healthcare Fraud Analytics Market is Predict to reach $6.6 Billion by 2028, at a CAGR of 23%
The market research report covers the analysis of key stake holders of the market. Key companies profiled in the report include Wipro Limited, IBM Corporation, DXC Technology Company, SAS Institute, Inc., Conduent, Incorporated, HCL Technologies Ltd., UnitedHealth Group, Inc. (Optum, Inc.), OSP Labs, Cotiviti, Inc., and ExlService Holdings, Inc.
Scope of the Study
Market Segments Covered in the Report:
By Delivery Model
By Application
- Insurance Claim Review
- Pharmacy billing Issue
- Payment Integrity
- Others
By End User
- Public & Government Agencies
- Private Insurance Payers
- Third-party Service Providers
- Employers
By Solution Type
- Descriptive Analytics
- Predictive Analytics
- Prescriptive Analytics
By Country
- Brazil
- Argentina
- UAE
- Saudi Arabia
- South Africa
- Nigeria
- Rest of LAMEA
Key Market Players
List of Companies Profiled in the Report:
- Wipro Limited
- IBM Corporation
- DXC Technology Company
- SAS Institute, Inc.
- Conduent, Incorporated
- HCL Technologies Ltd.
- UnitedHealth Group, Inc. (Optum, Inc.)
- OSP Labs
- Cotiviti, Inc.
- ExlService Holdings, Inc.
Chapter 1. Market Scope & Methodology
1.1 Market Definition
1.2 Objectives
1.3 Market Scope
1.4 Segmentation
1.4.1 LAMEA Healthcare Fraud Analytics Market, by Delivery Model
1.4.2 LAMEA Healthcare Fraud Analytics Market, by Application
1.4.3 LAMEA Healthcare Fraud Analytics Market, by End User
1.4.4 LAMEA Healthcare Fraud Analytics Market, by Solution Type
1.4.5 LAMEA Healthcare Fraud Analytics Market, by Country
1.5 Methodology for the research
Chapter 2. Market Overview
2.1 Introduction
2.1.1 Overview
2.1.1.1 Market Composition and Scenario
2.2 Key Factors Impacting the Market
2.2.1 Market Drivers
2.2.2 Market Restraints
Chapter 3. Competition Analysis - Global
3.1 Market Share Analysis, 2021
3.2 Strategies Deployed in Healthcare Fraud Analytics Market
Chapter 4. LAMEA Healthcare Fraud Analytics Market by Delivery Model
4.1 LAMEA On-premise Market by Country
4.2 LAMEA Cloud Market by Country
Chapter 5. LAMEA Healthcare Fraud Analytics Market by Application
5.1 LAMEA Insurance Claim Review Market by Country
5.2 LAMEA Pharmacy billing Issue Market by Country
5.3 LAMEA Payment Integrity Market by Country
5.4 LAMEA Others Market by Country
Chapter 6. LAMEA Healthcare Fraud Analytics Market by End User
6.1 LAMEA Public & Government Agencies Market by Country
6.2 LAMEA Private Insurance Payers Market by Country
6.3 LAMEA Third-party Service Providers Market by Country
6.4 LAMEA Employers Market by Country
Chapter 7. LAMEA Healthcare Fraud Analytics Market by Solution Type
7.1 LAMEA Descriptive Analytics Market by Country
7.2 LAMEA Predictive Analytics Market by Country
7.3 LAMEA Prescriptive Analytics Market by Country
Chapter 8. LAMEA Healthcare Fraud Analytics Market by Country
8.1 Brazil Healthcare Fraud Analytics Market
8.1.1 Brazil Healthcare Fraud Analytics Market by Delivery Model
8.1.2 Brazil Healthcare Fraud Analytics Market by Application
8.1.3 Brazil Healthcare Fraud Analytics Market by End User
8.1.4 Brazil Healthcare Fraud Analytics Market by Solution Type
8.2 Argentina Healthcare Fraud Analytics Market
8.2.1 Argentina Healthcare Fraud Analytics Market by Delivery Model
8.2.2 Argentina Healthcare Fraud Analytics Market by Application
8.2.3 Argentina Healthcare Fraud Analytics Market by End User
8.2.4 Argentina Healthcare Fraud Analytics Market by Solution Type
8.3 UAE Healthcare Fraud Analytics Market
8.3.1 UAE Healthcare Fraud Analytics Market by Delivery Model
8.3.2 UAE Healthcare Fraud Analytics Market by Application
8.3.3 UAE Healthcare Fraud Analytics Market by End User
8.3.4 UAE Healthcare Fraud Analytics Market by Solution Type
8.4 Saudi Arabia Healthcare Fraud Analytics Market
8.4.1 Saudi Arabia Healthcare Fraud Analytics Market by Delivery Model
8.4.2 Saudi Arabia Healthcare Fraud Analytics Market by Application
8.4.3 Saudi Arabia Healthcare Fraud Analytics Market by End User
8.4.4 Saudi Arabia Healthcare Fraud Analytics Market by Solution Type
8.5 South Africa Healthcare Fraud Analytics Market
8.5.1 South Africa Healthcare Fraud Analytics Market by Delivery Model
8.5.2 South Africa Healthcare Fraud Analytics Market by Application
8.5.3 South Africa Healthcare Fraud Analytics Market by End User
8.5.4 South Africa Healthcare Fraud Analytics Market by Solution Type
8.6 Nigeria Healthcare Fraud Analytics Market
8.6.1 Nigeria Healthcare Fraud Analytics Market by Delivery Model
8.6.2 Nigeria Healthcare Fraud Analytics Market by Application
8.6.3 Nigeria Healthcare Fraud Analytics Market by End User
8.6.4 Nigeria Healthcare Fraud Analytics Market by Solution Type
8.7 Rest of LAMEA Healthcare Fraud Analytics Market
8.7.1 Rest of LAMEA Healthcare Fraud Analytics Market by Delivery Model
8.7.2 Rest of LAMEA Healthcare Fraud Analytics Market by Application
8.7.3 Rest of LAMEA Healthcare Fraud Analytics Market by End User
8.7.4 Rest of LAMEA Healthcare Fraud Analytics Market by Solution Type
Chapter 9. Company Profiles
9.1 Wipro Limited
9.1.1 Company Overview
9.1.2 Financial Analysis
9.1.3 Segmental and Regional Analysis
9.1.4 Research & Development Expenses
9.1.5 Recent strategies and developments:
9.1.5.1 Partnerships, Collaborations, and Agreements:
9.1.5.2 Acquisition and Mergers:
9.2 IBM Corporation
9.2.1 Company Overview
9.2.2 Financial Analysis
9.2.3 Regional & Segmental Analysis
9.2.4 Research & Development Expenses
9.2.5 Recent strategies and developments:
9.2.5.1 Partnerships, Collaborations, and Agreements:
9.2.6 SWOT Analysis
9.3 DXC Technology Company
9.3.1 Company Overview
9.3.2 Financial Analysis
9.3.3 Segmental and Regional Analysis
9.4 SAS Institute, Inc.
9.4.1 Company Overview
9.4.2 Recent strategies and developments:
9.4.2.1 Partnerships, Collaborations, and Agreements:
9.5 Conduent, Incorporated
9.5.1 Company Overview
9.5.2 Financial Analysis
9.5.3 Segmental and Regional Analysis
9.5.4 Research & Development Expense
9.6 HCL Technologies Ltd. (HCL Enterprises)
9.6.1 Company Overview
9.6.2 Financial Analysis
9.6.3 Segmental and Regional Analysis
9.6.4 Research & Development Expense
9.6.5 Recent strategies and developments:
9.6.5.1 Partnerships, Collaborations, and Agreements:
9.7 UnitedHealth Group, Inc. (Optum, Inc.)
9.7.1 Company Overview
9.7.2 Financial Analysis
9.7.3 Segmental Analysis
9.8 OSP Labs
9.8.1 Company Overview
9.9 Cotiviti, Inc.
9.9.1 Company Overview
9.10. ExlService Holdings, Inc.
9.10.1 Company Overview
9.10.2 Financial Analysis
9.10.3 Segmental and Regional Analysis
9.10.4 Research & Development Expenses
9.10.5 Recent strategies and developments:
9.10.5.1 Partnerships, Collaborations, and Agreements:
TABLE 1 LAMEA Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 2 LAMEA Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 3 LAMEA Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 4 LAMEA Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 5 LAMEA On-premise Market by Country, 2018 - 2021, USD Million
TABLE 6 LAMEA On-premise Market by Country, 2022 - 2028, USD Million
TABLE 7 LAMEA Cloud Market by Country, 2018 - 2021, USD Million
TABLE 8 LAMEA Cloud Market by Country, 2022 - 2028, USD Million
TABLE 9 LAMEA Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 10 LAMEA Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 11 LAMEA Insurance Claim Review Market by Country, 2018 - 2021, USD Million
TABLE 12 LAMEA Insurance Claim Review Market by Country, 2022 - 2028, USD Million
TABLE 13 LAMEA Pharmacy billing Issue Market by Country, 2018 - 2021, USD Million
TABLE 14 LAMEA Pharmacy billing Issue Market by Country, 2022 - 2028, USD Million
TABLE 15 LAMEA Payment Integrity Market by Country, 2018 - 2021, USD Million
TABLE 16 LAMEA Payment Integrity Market by Country, 2022 - 2028, USD Million
TABLE 17 LAMEA Others Market by Country, 2018 - 2021, USD Million
TABLE 18 LAMEA Others Market by Country, 2022 - 2028, USD Million
TABLE 19 LAMEA Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 20 LAMEA Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 21 LAMEA Public & Government Agencies Market by Country, 2018 - 2021, USD Million
TABLE 22 LAMEA Public & Government Agencies Market by Country, 2022 - 2028, USD Million
TABLE 23 LAMEA Private Insurance Payers Market by Country, 2018 - 2021, USD Million
TABLE 24 LAMEA Private Insurance Payers Market by Country, 2022 - 2028, USD Million
TABLE 25 LAMEA Third-party Service Providers Market by Country, 2018 - 2021, USD Million
TABLE 26 LAMEA Third-party Service Providers Market by Country, 2022 - 2028, USD Million
TABLE 27 LAMEA Employers Market by Country, 2018 - 2021, USD Million
TABLE 28 LAMEA Employers Market by Country, 2022 - 2028, USD Million
TABLE 29 LAMEA Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 30 LAMEA Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 31 LAMEA Descriptive Analytics Market by Country, 2018 - 2021, USD Million
TABLE 32 LAMEA Descriptive Analytics Market by Country, 2022 - 2028, USD Million
TABLE 33 LAMEA Predictive Analytics Market by Country, 2018 - 2021, USD Million
TABLE 34 LAMEA Predictive Analytics Market by Country, 2022 - 2028, USD Million
TABLE 35 LAMEA Prescriptive Analytics Market by Country, 2018 - 2021, USD Million
TABLE 36 LAMEA Prescriptive Analytics Market by Country, 2022 - 2028, USD Million
TABLE 37 LAMEA Healthcare Fraud Analytics Market by Country, 2018 - 2021, USD Million
TABLE 38 LAMEA Healthcare Fraud Analytics Market by Country, 2022 - 2028, USD Million
TABLE 39 Brazil Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 40 Brazil Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 41 Brazil Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 42 Brazil Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 43 Brazil Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 44 Brazil Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 45 Brazil Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 46 Brazil Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 47 Brazil Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 48 Brazil Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 49 Argentina Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 50 Argentina Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 51 Argentina Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 52 Argentina Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 53 Argentina Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 54 Argentina Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 55 Argentina Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 56 Argentina Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 57 Argentina Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 58 Argentina Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 59 UAE Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 60 UAE Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 61 UAE Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 62 UAE Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 63 UAE Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 64 UAE Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 65 UAE Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 66 UAE Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 67 UAE Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 68 UAE Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 69 Saudi Arabia Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 70 Saudi Arabia Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 71 Saudi Arabia Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 72 Saudi Arabia Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 73 Saudi Arabia Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 74 Saudi Arabia Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 75 Saudi Arabia Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 76 Saudi Arabia Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 77 Saudi Arabia Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 78 Saudi Arabia Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 79 South Africa Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 80 South Africa Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 81 South Africa Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 82 South Africa Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 83 South Africa Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 84 South Africa Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 85 South Africa Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 86 South Africa Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 87 South Africa Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 88 South Africa Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 89 Nigeria Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 90 Nigeria Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 91 Nigeria Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 92 Nigeria Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 93 Nigeria Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 94 Nigeria Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 95 Nigeria Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 96 Nigeria Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 97 Nigeria Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 98 Nigeria Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 99 Rest of LAMEA Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 100 Rest of LAMEA Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 101 Rest of LAMEA Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 102 Rest of LAMEA Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 103 Rest of LAMEA Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 104 Rest of LAMEA Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 105 Rest of LAMEA Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 106 Rest of LAMEA Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 107 Rest of LAMEA Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 108 Rest of LAMEA Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 109 Key Information – Wipro Limited
TABLE 110 Key information – IBM Corporation
TABLE 111 key information – DXC Technology Company
TABLE 112 Key information – SAS Institute, Inc.
TABLE 113 Key Information –Conduent, Incorporated
TABLE 114 Key Information – HCL Technologies Ltd.
TABLE 115 Key Information – UnitedHealth Group, Inc.
TABLE 116 Key Information – OSP Labs
TABLE 117 Key Information – Cotiviti, Inc.
TABLE 118 Key Information – ExlService Holdings, Inc.
List of Figures
FIG 1 Methodology for the research
FIG 2 Market Share Analysis, 2021
FIG 3 Swot analysis: IBM Corporation