ARGO: Overcoming Fraudulent Cases through Big Data Analytics

The healthcare and financial services industries require advanced, technology based software to increase business process effectiveness and support their unique needs. ARGO is an industry leader in providing cost efficient, flexible, analytics-based software solutions to meet complex business requirements. “We align our products, people and services in response to industry needs and market value. Our strength lies in subject-matter content expertise, which not only helps us to define the products, but also helps customers deploy those products,” said Max Martin, Chairman & CEO of ARGO, a Texas-based Big Data Analytics firm.

Martin coined the company ARGO with inspiration from the successful history of Colorado’s famous ARGO gold mine. Martin believes that any young company digging through the Big Data mine needs to acquire tremendous depth in analytical skills and seek employees with sharp mathematical and statistical capabilities to setup online, real-time automation environments to safeguard virtual data assets.

“Big Data in enterprises is growing day by day, as are the crimes that surround them. The financial services and healthcare industries are infested with internal fraud, fraudulent transactions, patient fraud, and other associated crimes,” he said. For example, most hospitals fail to notice duplicate records of patients going through their doors, pretending to be someone else for the sake of insurance coverage, leading to an estimated 30 percent incidence in patient fraud. To address these growing needs, ARGO provides analytical-driven fraud solutions across multiple lines of business and industries, including healthcare and financial services. As part of its Fraud Management solutions, ARGO equips financial institutions with tools to detect and prevent fraudulent activities and enables healthcare organizations to significantly decrease patient identity fraud.

To detect fraud for financial institutions, ARGO employs a strategy of optimizing false positives or improving the ratio of suspects to actual fraud to reduce monetary losses.

Industry metrics for false positives are 150-200 to 1. “This means fraud analysts review 150-200 suspected transactions, and only one is fraudulent [on an average]. This process is labor intensive and very inefficient. But with ARGO’s Fraud Management solutions, the ratio is improved to 45 to 1, which means that by utilizing advanced analytics, we help organizations increase cost efficiency and detection rates,” said Martin.

In healthcare, the ARGO Entity Match & Resolution solution enables evaluation, accurate linking, and resolution of data from multiple systems and sources. ARGO’s probabilistic matching engine within the Enterprise Master Person Index (EMPI) accurately establishes and maintains unique records and identifiers, lowering duplicate rates to as low as 0.5 percent while helping healthcare organizations achieve meaningful use standards, reduce costs, and improve quality of care and patient safety.

For financial services, ARGO designs deterministic solutions for cash management and workforce scheduling. Cash Inventory Optimization utilizes a next-generation system designed to shrink inventory and courier costs, decrease outages and emergency orders, and monitor reduction goals. Workforce Management maximizes productivity by uncovering historical trends and using real-time inputs to forecast transaction volumes, predict customer traffic patterns, and create staffing recommendations.

Serving the financial services industry for more than 30 years, ARGO is the software solutions partner of choice for seven out of top 10 U.S. financial institutions. In its healthcare sector, ARGO provides solutions to one of the top healthcare systems in North America with more than 40 hospitals. “Rather than selling analytical tools to customers, ARGO designs, builds, and implements software solutions to meet customers’ needs. We also constantly monitor the solutions for further efficiency improvements,” said Martin.

Going forward, ARGO continues to define innovative initiatives to increase fraud detection and prevention. These initiatives focus on increasing operational efficiency, decreasing costs, and improving the end customer’s or patient’s experience.