Case Studies

Automating Data Pipelines and Network Entity Detection

Elder Research developed an automated data pipeline to cleanse data from millions of documents and feed a data visualization tool used to explore and identify risky network relationships. The solution enabled the client to automate significant portions of work saving time and cost, make data-driven decisions, prioritize investigative resources, and gain new business value from the data.

Automating Textual Data Discovery And Analysis

Elder Research designed and deployed tools for high-end text mining to search, index, and automatically classify information related to animal infectious diseases. The solution enabled analysts to validate incidents of animal disease and make recommendations for dealing with them at the earliest stage possible.

Detecting Fraudulent Workers' Compensation Claims

Department of Labor Office of Inspector General (DOL-OIG) contracted with Elder Research to create a predictive model to detect fraud in Office of Workers’ Compensation Program (OWCP) data. The goals of this project were to highlight abnormalities in the claims data that could be used to form the basis of future audits and to create visualization tools to enable auditors to explore model results. The RADR tool amplifies the productivity of DOLOIG auditors and reduced case investigation time from days to hours, combining client goals and expertise with objective measures of risk

Detecting Healthcare Insurance Fraud, Waste, and Abuse

Elder Research developed an advanced analytics prototype to detect potential fraud, waste, and abuse by Medicare and Medicaid dental insurance service providers. The analytics solution increased fraud detection by a factor of ten and enabled the client to more efficiently target suspect claims for investigation.

Determining Influential Factors for Conference Customer Satisfaction

Elder Research text mined survey data and provided exploratory and predictive analysis to identify insights and trends that affected conference attendance. This helped guide the client’s conference content programming and global conference planning.

Discovering the Efficacy of a New Drug

After investing heavily to investigate a new potential drug, the compound was not passing the statistical tests required by the FDA. Pharmacia & Upjohn invited Elder Research to examine the data 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.

Improving Claims Approval Speed and Accuracy

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

Improving Credit Card Risk Scoring

Elder Research examined a dozen major data mining techniques to evaluate their performance and gain insight on which credit card accounts were likely to default compared to the client’s world-class baseline model. The resulting model ensemble significantly improved early identification of bad credit risks.

Improving Customer Retention and Profitablity

By applying advanced techniques for modeling and visualizing customer records, Elder Research created a combined data and text mining solution to increase mar- keting efficiency and reduce churn. The model improved targeted messages which resulted in higher profitability for nTelos, a regional mobile phone carrier.

Improving Service Provider Performance and Patient Outcomes

DentaQuest engaged Elder Research to improve on existing models used for assessing the performance of Medicaid Dental providers. The goal was to create a single simplified risk score that would provide a holistic 360 degree view for each service provider. We developed a provider risk scoring model that enabled targeted intervention with low quality providers and reduced per patient cost by nearly 20 percent.

Improving Unemployment Insurance Claim Fraud Detection

Elder Research designed and deployed an automated fraud detection solution for the New York Department of Labor Unemployment Insurance Integrity Center of Excellence. The tool was estimated to have identified 1200 claims annually before the current investigative process with annual projected savings of $972,000 in recoverable and nearly $392,000 in non-recoverable overpayments.

Improving Workers' Compensation Provider Fraud Detection

Elder Research designed and deployed an automated fraud detection and visualization solution for a national Workers’ Compensation Insurance Program to improve the efficiency of fraud detection and investigation by prioritizing high-risk cases.. Investigations and forensic analysis that took hours can now be completed in minutes, making the most efficient use of limited and valuable resources.

Optimizing Federal Workers Compensation Claims Approval

Elder Research developed a data-driven risk assessment framework to triage Worker’s Compensation claims, prioritizing high risk cases for review and fast-tracking other cases to avoid manual review and adjudication. Claims that are routed to the fast track are assigned risk-based maximum payment limits for intelligent ongoing claims management.

Predicting Financial Account Churn

Elder Research partnered with a diversified bank to predict account closures, prioritize marketing interventions, and understand precursors to customer churn. We built a model that was 20% more effective at predicting customer churn than existing techniques.

Prioritizing Building Lease Renewal Risk

Elder Research created a risk model to help the U.S.Postal Service Office of Inspector General prioritize review of facility leases that were due for renewal. The risk model enabled business analysts renegotiating lease rates to focus on facilities with the most risk or highest financial impact. Projected savings was $99 million over 5 years.

Prioritizing Long-Term Care Claims

Elder Research developed a risk scoring model to optimize the management of long-term care claims. The regression model successfully predicted which claims would experience expanded payout over time, identifying claims most in need of clinical review. The proactive recommendations for patient service resulted in better patient care and more efficient claims management.

Reducing Fraud, Waste, and Abuse

Elder Research partnered with the U.S. Postal Service Office of Inspector General to develop and deploy a custom solution to identify and prioritize questionable contracts and healthcare claims for investigation. Leads generated were 74% actionable, resulting in over $11 million in recoveries, restitutions, and cost avoidance in the first year.

Reducing Service Provider and Warranty Fraud

Elder Research designed, prototyped, piloted, and deployed an automated service provider and warranty fraud detection system. The solution prioritized investigative workload to maximize resource utilization and minimize loss to fraud and is credited with saving over $67 million in service provider and warranty fraud.

Staffing Simulation and Optimization

Peregrine Systems advanced to the forefront of the IT management industry by partnering with Elder Research data mining and software development experts to develop its DecisionCenter software. IT executives can now accurately predetermine how changes made to staff and infrastructure resources will affect business.

Text Mining Unlocks Valuable Data from Scanned Insurance Documents

Elder Research largely automated the extraction of valuable underwriting information from scanned Attending Physician Statement documents using text mining tools and techniques. Extracted text features were transformed into electronic formats suitable for predictive modeling.

Understanding Customer Sentiment From Survey Results

Elder Research applied state-of-the-art text mining techniques to the problem of sentiment analysis. The solution focused on the entire survey text rather than limiting analysis to lists of positive and negative keywords. This approach more accurately identified important issues and ignored off-topic comments, leading to more focused action and improved customer loyalty.

Using Marketing Analytics to Enhance Customer Loyalty

Elder Research created an automated evaluation of the impact a printer supplies loyalty program had on customer lifetime value, retention, and market share. The solution increased program enrollment by 35%, resulting in more than $600 million in sales over five years.

Using Product Usage Analytics to Improve User Experience

Elder Research developed a user segmentation model based on SolidWorks’ software usage logs. These segments, reproducible with 92% accuracy, served as the basis for helping SolidWorks employ product log analytics to better understand, communicate with, and serve their users.

Using Sensor Analytics to Predict Natural Gas Well Freezing

Elder Research used sensor data to develop risk models that predicted well freezes with 70% accuracy, enabling targeted well intervention to reduce freeze remediation cost and recover gas production that would have been lost or deferred.

Validating A Predictive Model Of Maritime Casualty Risk

Elder Research validated the processes and methodologies applied by RightShip in the development of RightShip Qi, a new model that enhances maritime safety by predicting the casualty risk of ships. With the new RightShip Qi model, the organization seeks to take ship vetting to an entirely new level by implementing a data-driven solution with machine learning techniques.

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