{"id":7025552,"date":"2026-08-03T19:18:16","date_gmt":"2026-08-03T19:18:16","guid":{"rendered":"https:\/\/peraltafinancing.com\/uncategorized\/why-ai-finally-changes-the-math-on-fraud-waste-abuse-in-healthcare-ramaonhealthcare\/"},"modified":"2026-08-03T19:18:16","modified_gmt":"2026-08-03T19:18:16","slug":"why-ai-finally-changes-the-math-on-fraud-waste-abuse-in-healthcare-ramaonhealthcare","status":"publish","type":"post","link":"https:\/\/fivemor.com\/?p=7025552","title":{"rendered":"Why AI Finally Changes the Math on Fraud, Waste, &#038; Abuse in Healthcare \u2013 RamaOnHealthcare"},"content":{"rendered":"<p> <br \/>\n<\/p>\n<div id=\"post-408287\">\n<div class=\"rama-ads-banner\"><center><a class=\"fusion-no-lightbox\" data-id=\"86044\" href=\"https:\/\/ramaonhealthcare.com\/advertising\/?utm_source=RAMA&amp;utm_medium=Website\" target=\"_blank\" aria-label=\"RamaOnHealthcare - Advertise With Us\"><img decoding=\"async\" src=\"https:\/\/cdn.ramaonhealthcare.com\/wp-content\/uploads\/2020\/12\/roh-ad.webp\" alt=\"RamaOnHealthcare - Advertise With Us\" class=\"img-responsive\" width=\"865\"\/><img decoding=\"async\" src=\"https:\/\/cdn.ramaonhealthcare.com\/wp-content\/uploads\/2020\/12\/roh-ad.webp\" alt=\"RamaOnHealthcare - Advertise With Us\" class=\"lazyload img-responsive\" width=\"865\"\/><\/a><\/center><\/div>\n<div class=\"post-content\">\n<p class=\"rama-front-source-post\"><span class=\"rama-front-source-name\">HIT Consultant<\/span> <span class=\"rama-front-source-date\">August 3, 2026<\/span><br \/><span class=\"rama-front-source-author\">Kasra Khadem, Partner at Pathlight Ventures<\/span><\/p>\n<p>The U.S. health care system loses more than <a href=\"https:\/\/www.hhs.gov\/guidance\/document\/national-health-expenditure-nhe-fact-sheet\"><u>$100 billion a year<\/u><\/a> to fraud, waste, and abuse, and by some estimates several times that. We have known this for decades. What is new is that the technology to catch it has finally caught up. The question is no longer whether the tools work; it is whether the institutions processing and paying the faulty claims will finally use them.<\/p>\n<p>What the system is actually losing<\/p>\n<p>Three different problems get lumped together, so it is worth separating them.<\/p>\n<ul>\n<li>Fraud is intentional deception: billing for services never rendered, phantom patients, kickback rings. The <a href=\"https:\/\/www.nhcaa.org\/tools-insights\/about-health-care-fraud\/the-challenge-of-health-care-fraud\/\"><u>National Health Care Anti-Fraud Association<\/u><\/a> estimates fraud alone at 3 percent of health spending on the low end, and&#8230;<\/li>\n<\/ul>\n<div id=\"rama-ads-mobile\">\n<h2 style=\"padding-top: 10px;\" class=\"rama-front-content-title-bar\">Today&#8217;s Sponsor<\/h2>\n<div class=\"rama-ads-block\"><a class=\"fusion-no-lightbox\" data-id=\"324265\" href=\"https:\/\/venturous.work\/?utm_source=RAMA&amp;utm_medium=Website\" target=\"_blank\" aria-label=\"Venturous\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/cdn.ramaonhealthcare.com\/wp-content\/uploads\/2025\/02\/400-venturous-200x100.webp\" alt=\"Venturous\" class=\"img-responsive\" width=\"200\" height=\"100\"\/><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/cdn.ramaonhealthcare.com\/wp-content\/uploads\/2025\/02\/400-venturous-200x100.webp\" alt=\"Venturous\" class=\"lazyload img-responsive\" width=\"200\" height=\"100\"\/><\/a><\/div>\n<\/div>\n<p>\u00a0<\/p>\n<p>Related Articles:<\/p>\n<\/div>\n<p> <span class=\"updated rich-snippet-hidden\">2026-08-03T10:29:52-04:00<\/span><\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>HIT Consultant August 3, 2026Kasra Khadem, Partner at Pathlight Ventures The U.S. health care system loses more than $100 billion a year to fraud, waste, and abuse, and by some estimates several times that. We have known this for decades. What is new is that the technology to catch it has finally caught up. The [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":7025553,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[189176,97858,153170,91],"tags":[16834,13532,7385,11178,4391,4210,105638,8586],"dealstore":[],"offerexpiration":[],"class_list":["post-7025552","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ai-artificial-intelligence-3","category-articles","category-provider","category-technology","tag-abuse","tag-articles","tag-finally","tag-fraud","tag-healthcare","tag-math","tag-ramaonhealthcare","tag-waste"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Why AI Finally Changes the Math on Fraud, Waste, &amp; Abuse in Healthcare \u2013 RamaOnHealthcare - Som2ny Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/fivemor.com\/?p=7025552\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Why AI Finally Changes the Math on Fraud, Waste, &amp; Abuse in Healthcare \u2013 RamaOnHealthcare - Som2ny Network\" \/>\n<meta property=\"og:description\" content=\"HIT Consultant August 3, 2026Kasra Khadem, Partner at Pathlight Ventures The U.S. health care system loses more than $100 billion a year to fraud, waste, and abuse, and by some estimates several times that. 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