Fraud, Risk and Improper Payments Demo Script

Fraud, Risk and Improper
Payments Demo Script
Sanjeev Vohra
System Engineer
Government Operations Engineering Team
Copyright © 2006, SAS Institute Inc. All rights reserved.
Purpose of the Demo
 This demo is designed to illustrate key features
in the SAS 9 platform that help combat fraud,
risk and improper payments in the public sector.
Although this demo focuses on health care fraud,
the principles that are illustrated in this demo can
be leveraged in other areas, also. The areas to
focus this demo on are:
 The SAS Information Delivery Portal – Especially
the dashboard feature.
 The single sign-on for Web Report Studio
 The seamless drilling on dashboards, graphs
and reports.
 The ability to incorporate tables into your
analysis that are not part of your warehouse
Copyright © 2006, SAS Institute Inc. All rights reserved.
The Business Problem
 You are the Deputy Assistant (DA) of Anti-Fraud for your agency’s
health care interest, and have been mandated by Congress to
reduce fraud in your area by 10 % -15 %.
 How you approach the solution is entirely at your discretion,
Congress has expressed interest to understand how you come up
with your solution. You work with your team to develop with a plan
of attack, which is three pronged:
 Eliminate duplicate payments
 Redouble efforts to ensure that providers servicing patients are
indeed providing legitimate services to those patients.
 Evaluate beneficiaries who have prescriptions refilled repeatedly,
even before their prescriptions are over.
 Of course, there is little value in simply presenting your without fully
understanding the impact of your strategy. Therefore, a “what-if”
component is the final piece of this puzzle.
 You have to submit a report a Congress by the end of this week in
a format that’s clear, easy to understand, portable. Where do you
start?
Copyright © 2006, SAS Institute Inc. All rights reserved.
Intended Audience
 The target audience of this demonstration is
information consumers who benefit from work
already done for them, and then review this work
in a personalized interface. Although this
demonstration does have an analytics piece, it is
not meant to leverage all of the capabilities of
Enterprise Miner. Similarly, there is a DI
component to this demo, however, this demo is
not a DI demo; it is a platform demo.
 This demo has three personas that would benefit
from this product demonstration. These are:
• Information consumer – Information Delivery Portal
User
• Information analyst – Web Report Studio and EG user
• Data analyst – DI Studio User
Copyright © 2006, SAS Institute Inc. All rights reserved.
Screen Shots
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.
Copyright © 2006, SAS Institute Inc. All rights reserved.