Healthcare

 

Client challenge

The client needed help flagging fraudulent medical insurance claims. The goal was to:

  • Determine logic to flag suspicious behavior and identify providers of interest
  • Leverage billing data to analyze suspicious providers

 

How we helped
  • We performed fuzzy matching to link multiple claim records to the same provider(s)
  • We used geocoding to create physical distance calculations between providers and between providers and claimants
  • We applied statistical methods (e.g., logistic ridge regression with sparse matrices, T-Score calculation, bootstrapping, etc.) to billing data to build propensity scoring models to rule claims as valid or invalid
  • Based on our modeling results, we created the fraud flagging logic to identify suspicious behavior and providers of interest
  • The team collaborated with the investigative unit, billing unit, and legal unit to create a provider fraud action plan

 

Fulcrum's data preparation procedures and predictive analytical models provided the quantitative basis for the provider fraud action plan.

 

Client challenge

A leading eyewear distributor was looking for analytical guidance to power their sales and marketing efforts and overcome challenges related to:

  • Cross brand affinity
  • Returns
  • Ideal price point
  • Customer lifetime value

 

How we helped
  • We provided deep analysis and customer relationship management consulting using advanced data modeling and analytics
  • We provided campaign management, campaign contact strategy, and campaign operations for multiple brands in the portfolio
  • Our Anvil™ platform hosted the CRM database and leveraged APIs with the client and its third party data sources

 

Fulcrum’s advanced data modeling and technology platform enabled a data-driven end-to-end sales and marketing operation.

 

Client challenge

A leading medical insurance company was seeking data driven campaign strategy, models, and marketing operations to accelerate their acquisition efforts.

 

How we helped
  • Our Anvil™ platform securely hosted the HIPAA-compliant marketing database, and managed APIs, householding, suppressions, NCOA updates, opt-outs, etc. 
  • We built predictive models to improve sales and marketing targeting and efficiency, including retention models for renewals. 
  • Through building and implementing response, attrition, and best customer look alike models we evaluated data sources while providing cross-channel campaign solutions.


Using Fulcrum’s Anvil platform we built, hosted, and maintained a HIPAA-compliant and model-driven marketing database for cross-channel campaign solutions.

 

Client challenge

A medical supplier of blood glucose monitors and strips was seeking to increase their sales

They sought to identify the needs and habits of their customers and the feasibility of increasing sales through the offering of competitors’ products on its website.

 

How we helped
  • We acquired customer and prospect lists from the manufacturer and analyzed existing customers and prospects’ blood glucose strip spending habits
  • We designed a questionnaire to probe on blood glucose strip purchase behavior and blood glucose testing behavior and determine where blood glucose strip users get supplies, brands used, and the frequency in which they test
  • We uncovered key behavioral and target audience information to better convert individuals into repeat customers


Fulcrum securely handled client and prospect lists for telephone survey recruitment, designed the questionnaire, administered the survey, analyzed results to determine the best course of action, and provided key targeting and strategy information for increasing eCommerce sales.

 

Client challenge

A well known weight loss service provider was seeking to:

  • Deepen analytical insights for maximizing campaign effectiveness
  • Analyze customer spending and attrition behavior 
  • Conduct campaign analysis and reporting metrics

 

How we helped
  • We developed a robust marketing database on Fulcrum’s Anvil™ platform to integrate data from multiple sources.
  • We provided analytical models for customer spending, attrition, lifetime value, and segmentation to inform marketing campaigns
  • We measured campaign success and refined future campaigns through a process of continuous improvement

 

Our team facilitated a data-driven direct-to-customer marketing operation with ongoing ROI measurement and a feedback loop of continuous improvement.

 

Client challenge

A leading blood glucose monitor manufacturer sought to:

  • Modernize its communication streams 
  • Develop cross-channel communication coordination

 

How we helped
  • Our Anvil™ platform securely hosted the HIPAA-compliant marketing database and managed APIs. 
  • We built predictive models to improve customer retention and winback in the context of customer lifetime value.  
  • We provided ongoing cross-channel campaign experimental design and response analysis. 
  • We designed and carried out customer research to fine tune multi-channel communication messaging and strategy

 

Our data science team built comprehensive predictive models to execute upon cross-channel factors that retain customers while conducting deep market research to maximize relevant communication.

 

Client challenge

The client was seeking support in evaluating various clinical programs. Key challenges included:

  • Many clinical programs were operating without a randomized control group
  • Historical evaluations were done in a time consuming and ad-hoc fashion
  • There was a lack of consistency in evaluation scope and methodology across different clinical programs
  • All of the above made it difficult to track changes and updates

 

How we helped
  • We built matched control groups at the patient levels by matching patients enrolled in certain clinical programs with comparable patients who were not enrolled, based on a number of relevant criteria
  • We calculated various outcome metrics to evaluate the program’s impact at the patient level
  • The finely matched control group process allowed for result measurement by other important dimensions such as severity of illness, market, etc.
  • We developed automated scripts to reduce labor hours for future updates

 

Fulcrum's quasi-experimental design process allowed for program result measurement where there was no hold-out control group. We also developed automated scripts to increase consistency in methodology and reduce labor hours for future program measurement.