Tag Archives: case management

Tennessee county turns to Case Closed for investigation management

(March 27, 2017) Case Closed™ Software, a division of crime fighting software leader Crime Tech Solutions, LLC, announced today that they have signed contract with a large well-known and historic county in Tennessee.
tennesseeThe mid-sized Sheriff’s Department in the Volunteer State chose Case Closed Software after a long, thorough search for a solution provider capable of delivering “a feature-rich, affordable solution for managing investigations and the investigative unit”. The core modules of the software include Investigative Case Management, Link Analysis, Confidential Informants Management, Property & Evidence, Gang Tracking, and Departmental Reporting. According to a company spokesperson, the software also includes a mobile application for investigators in the field, and real-time alerting designed to help agencies solve crimes faster.
Case Closed Software said that the solution is being installed immediately, and that the agency will be fully implemented by April 30, 2017.
For more information on Case Closed, visit www.caseclosedsoftware.com
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The Case for Investigative Case Management

Lost in the news of the recent demise of New Zealand based crime-fighting software developer Wynyard Group, is an interesting report published just weeks before the company ceased operations.

55According to the study, just 55% of U.S. law enforcement agencies currently utilize investigative case management software (CMS), and the majority of users are unhappy with their current systems.

Thirty-seven percent of the study respondents are not currently using any type of automated system, and rely mainly on paper files and spreadsheets to manage their investigations.

Investigative case management software has long been the domain of larger agencies and departments, and is only now truly affordable for smaller departments. The software allows investigators to manage the investigation process from start to finish. The more robust software allows agencies to assign cases and tasks, manage deadlines, store and maintain physical and multimedia evidence, and to search for relevant information across disparate databases.

According to a press release issued at the time, the survey queried users on how likely they would be to recommend their current system to another agency. While most users were unhappy with their current investigative case management system, there was a clear difference between agencies using commercial-off-the-shelf (COTS) software and those using home grown, legacy systems. The latter fared very poorly in the survey results.

The survey also measured the use of smart devices by front-line officers. Forty three percent indicated that they currently utilize smart phones and tablet computers, and 23% indicated they had neither device.

The most-desired features in investigative management software include:

  • Management Dashboards
  • Reports – Standard and ad hoc
  • Case Assignment and Reminders
  • Actions and Incident Management
  • Mobile and Front-Line Case Access
  • Evidence Management and Chain-of-Custody
  • Multimedia Handling
  • Audit Logs
  • Collaboration
  • Gangs and Organized Crime Management
  • Data Visualization and Link Analysis
  • Case Closure / Evidence Brief

An investigative case management system for law enforcement and commercial investigation agencies is rapidly becoming a ‘must-have’. In an era of shrinking budgets and competing resources, a high value is placed on getting the biggest ‘bang for the buck’. The study indicates that agencies are looking to maximize the value of their investigative case management software by incorporating a robust feature set with an affordable price.

Case Closed Software, a division of Crime Tech Solutions, is a powerful and affordable investigative case management solution for law enforcement agencies. Case Closed is also available via the cloud with the innovative Case Closed Cloud. Created by former law enforcement investigators, the COTS software is designed with ease-of-use in mind. The software is deployed in agencies – large and small – across the country.

Wynyard Group's slow, painful death arrives. Now, what about the customers?

October 28, 2016 – Crime Tech Solutions, a fast-growing and vibrant investigation software company based in Austin, TX, today announced a migration path for software users affected by the recent failure of New Zealand based Wynyard Group. Wynyard had positioned itself as a ‘leader in crime fighting software’, but never did find traction in the markets they coveted.

wynyardfailPer Wynyard Group officials, the company has placed itself in voluntary administration as it battles crippling losses and missed revenue forecasts, leaving customers in the dark as to the future of their investment in the crime fighting technology.

For users of the Wynyard Group case management software, Crime Tech Solutions has introduced a comprehensive ‘path forward’ that includes, in some cases, a license-cost-free replacement of the Wynyard Group system with the popular and robust Case Closed™ investigative case management solution for law enforcement and commercial investigation agencies.

Case Closed Software was developed by investigation professionals and for investigation professionals, and is widely used by investigative agencies across North America.

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“The objective”, said Crime Tech Solutions’ CTO Keith Weigand, “is to provide Case Closed software licenses to interested customers in exchange for the monies they already pay in annual maintenance and support.”

Tyler Wood, Operations Manager at Crime Tech Solutions, added “In essence, it’s a way to put what we think is better case management software into customers’ hands without the need to pay for expensive new software licenses.” While Wood acknowledges that there are internal costs associated with converting to any new solution, he feels that the intuitive and flexible nature of Case Closed is designed to mitigate those costs as much as possible.

About Crime Tech Solutions

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Case Closed Software is developed and supported by fast-growing Crime Tech Solutions

 

Crime Tech Solutions  is a low price / high performance innovator in crime analytics and law enforcement crime-fighting software. The clear price/performance leader for crime fighting software, the company’s offerings include Case Closed™ investigative case management and major case management, GangBuster™ gang intelligence software, powerful Sentinel Visualizer link analysis software, evidence managementmobile applications for law enforcement, comprehensive crime analytics with mapping and predictive policing, and 28 CFR Part 23 compliant criminal intelligence database management systems.

Critical Capabilities for Case Management Software? Case Closed!

In a February 2014 report, Critical Capabilities for Case Management, Gartner Group® defined the following 11 critical capabilities for investigative case management solutions. Crime Tech Solutions applies all of these critical capabilities to the powerful CASE CLOSED™ SOFTWARE for deployment at government and commercial investigative groups. 

  1. ccscreenshot1Investigative case management solutions always require a broad range of data types, from highly structured data (such as an individual’s name, address or ID) to highly unstructured data (such as scanned images, blueprints, faxes, email communications, and audio or video files). CASE CLOSED supports this requirement with unique and patented functionality that allows investigators to interact with this content, using capabilities such as view or read, comment, highlight, update or change, and append.
  2. Supports a broad range of collaboration services to facilitate individual and group interactions among all (internal and external) case participants. Collaboration among people (and even potentially with third party software) is incorporated into CASE CLOSED so that all interactions are recorded as part of the audit trail of how a case is handled. CASE CLOSED’s built-in support for e-mail communications, messaging, and alerting further supports collaboration efforts – across the aisle or across departments.
  3. Interoperates well with other external content and process services. Successful investigations and prosecutions often depend on external content and process services from repositories and applications. The attraction of CASE CLOSED’s open, standard specifications is that enterprises will know that integration with content repositories, web portals, and external software will require less custom code or specialized adapters.  ccscreenshot2
  4. Provides vertical – and horizontal – specific data models, nomenclature, hierarchies and case life cycle management. Crime Tech Solutions has substantial experience in specific domains such as financial crimes and law enforcement investigations. We have transferred the lessons learned from consistent use cases and data definitions directly into CASE CLOSED. Because investigative case management solutions are difficult to design and architect, such out-of-the-box configuration patterns tend to accelerate the implementation time.
  5. Provides application adapters to industry and domain-specific environments. Crime Tech Solutions constantly endeavors to integrate with our customers’ critical systems of record. Crime Tech Solutions is well-acquainted with the specialized applications and data sources that dominate certain industries and domains, and thus CASE CLOSED offers accelerated integration with core systems of record.
  6. Provides comprehensive, highly configurable, role-based user experiences. Designed by former law enforcement officials, CASE CLOSED offers role-based user interfaces that tend to focus and simplify case handling – a critical step toward productivity gains. Crime Tech Solutions idealizes the interface between case workers, the content in cases and the managers who make decisions based on the work in progress.
  7. Provides business-role-friendly dashboards, metrics and reporting. Investigative groups want flexible and powerful case management solutions that allow them to manage and modify their own solutions, and to get meaningful information from them. As a result, CASE CLOSED provides access to case execution history, as well as appropriate dashboards, models, visualizations, reports and other tools to monitor, analyze and report on case handling.casestatistics
  8. Supports a broad range of case orchestration, from highly structured to highly unstructured flows. CASE CLOSED provides case orchestration for a spectrum of applications, ranging from very structured (predictable sequences of activities, usually represented in a flow model) to very unstructured (where progression is not easily predictable, and ad hoc activities may be invoked during the execution of the case). CASE CLOSED is also designed to easily adapt to the investigation group’s evolving business processes.
  9. Has been proven in deployments with 100,000 cases or more annually which is especially important for areas such as claims management and fraud investigations. While some investigative case management deployments do not require the volume capabilities of 100,000 cases or more, others do. Crime Tech Solutions’ software has been designed – and has been deployed – with very large scale case handling as a critical capability.
  10. Provides intelligent and versatile on-ramps and off-ramps for incorporating content (such as document capture, mobile phone cameras, fax servers and e-forms). It doesn’t matter how the information exists, whether on paper, in a digital document, as an image, in an email, in a voice mail or on the internet: CASE CLOSED is designed to allow capture and control with as much upfront intelligence as possible. Coupled with the ability to deliver various inbound content objects to a case folder is the ability for CASE CLOSED to generate outbound content (such as e-Brief), and the ability to export case data.
  11. Leverages models for easy adaptability of the solution. CASE CLOSED leverages appropriate data models to enable business and technical roles to easily adjust their solutions as needed. This includes easy adaptation of the design as well as easy adaptation of executable behavior. Importantly, CASE CLOSED provides the ability for dynamic and ad hoc adjustments to in-flight work. This means that the execution path of in-flight cases can be immediately adjusted in an unanticipated (ad hoc) way.

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According to Gartner, investigative cases are the most complex in terms of process (workflow) and content (data). These cases are data-heavy. Often, data is captured as part of the case and relationships between data elements emerge over time. Patterns in the data are discovered, evaluated and acted on. Sequencing of actions on the case is very ad hoc, and event/milestone-driven.
Figure 1 shows examples of case-based processes that fall under each of these four use-case categories, and shows the structured vs. unstructured nature of the processes and data associated with each.
Figure 1. Case-Based Processes
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Source: Gartner (February 2014)
CASE CLOSED SOFTWARE from Crime Tech Solutions is designed specifically for the Investigative (data-heavy) market and resides in the upper right quadrant of diagram.
About the Author
Tyler Wood is Operations Director of Austin, TX based Crime Tech Solutions (www.crimetechsolutions.com). The company develops and deploys low price / high performance software for law enforcement including Case Closed investigative case management software, sophisticated Sentinel Visualizer link analysis and data visualization software, and CrimeMap Pro advanced crime analytics. The company also develops the popular GangBuster gang database, and IntelNexus criminal intelligence software for 28 CFR Part 23 compliance.

Overland Park senior crime analyst Jamie May joins Crime Tech Solutions

September 16, 2016 – (Leander, TX)  Crime Tech Solutions, a fast-growing provider of low cost / high performance crime fighting software and analytics is delighted to announce the addition of Jamie May as senior analyst and strategic advisor to the company.

jamiemayMs. May has spent over 17 years as a crime and intelligence analyst for Overland Park Police Department in Kansas, and is a recognized expert in crime analysis, mapping, and criminal intelligence. She has sat on critical crime analysis committees including the International Association of Crime Analysts’ Ethics Committee (IACA) and is a past Vice President / Secretary at Mid American Regional Crime Analyst Network (MARCAN).

“Jamie brings an incredible amount of user experience and innovation to the company”, said Kevin Konczal, Crime Tech Solutions’ VP of Sales. “She’s been active in this community for years, and co-authored the ground-breaking guide, GIS in Law Enforcement: Implementation Issues and Case Studies.”

“To me, Crime Tech Solutions represents a truly innovative company that understands how to develop and market very good technology at prices that most agencies can actually afford”, said Ms. May. “I’m looking forward to being part of the continued growth here.”

In her role with the company, Ms. May will interact with customers and prospects to help align the company’s solution strategy with market and user requirements.

black versionCrime Tech Solutions, who earlier this year acquired TN based Case Closed Software, delivers unique value to customers with comprehensive investigative case management software, sophisticated link analysis tools, criminal intelligence management software, and crime mapping technology that includes some of the industry’s best analytics and reporting capabilities.

 
 
 
 

Using crime analysis solutions to take a ‘Byte’ out of crime

_KOK1002_RTCC+(3)Posted by Crime Tech Solutions 
Law enforcement agencies everywhere are tasked with reducing and investigating crime with fewer and fewer resources at their disposal. “To protect and serve” is the highest responsibilities one can sign up for, particularly in light of recent well-publicized criticisms of police by activists in every city.
That responsibility weighs even heavier in a world with no shortage of criminals and terrorists. There’s never enough money in the budget to adequately deal with all of the issues that face an individual agency on a daily basis. Never enough feet on the street, as they say.
New Tools for Age-Old Problems
Perhaps that’s why agencies everywhere are moving to fight crime with an evolving 21st century weapon – law enforcement software including investigative case management, link and social network analysis, and, importantly, crime analytics with geospatial and temporal mapping.
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Crime analytics and investigation software have proven themselves to be valuable tools in thwarting criminal activity by helping to better define resource allocation, target investigations more accurately, and enhancing public safety,
According to some reports, law enforcement budgets have been reduced by over 80% since the early 2000s. Still, agencies are asked to do more and more, with less and less.
Analytics in Policing

Analytics
Predictive Analytics for Policing

Analytics in law enforcement  play a key role in helping law enforcement agencies better forecast what types of crimes are most likely to occur in a certain area within a certain window of time. While no predictive analytics solution offers the clarity of a crystal ball, they can be effective in affecting crime reduction and public safety.
Predictive analysis, in essence, is taking data from disparate sources, analyzing them and then using the results to anticipate, prevent and respond more effectively to future crime. Those disparate data sources typically include historical crime data from records management systems, calls for service/dispatch information, tip lines, confidential informant information, and specialized criminal intelligence data.
The Five W’s of Predictive Analytics
Within this disparate data lie the 5 W’s of information that can be used by crime analysis software to build predictions. Those key pieces include:

  1. Arrest records – who committed crimes
  2. Geospatial data – where crimes have occurred
  3. Temporal data – when crimes have occurred
  4. Statistical data – what crimes have occurred
  5. Investigation data – why (and how) the crimes occurred

5W
Using the 5 W’s, agencies are able to gain insight and make predictions about likely future criminal behavior. For example, if a certain type of crime (what) tends to occur in ‘this’ area (where) at ‘this’ time (when), and by ‘this’ type of individual (who) for ‘this’ reason (why)… it would be wise to deploy resources in that area at that time in order to prevent the incidents from ever occurring. This, of course, is a dramatic over-simplification of the types of analytics that make up predictive policing, but illustrates the general concept well.
Although criminals will always try to be one step ahead of the law, agencies deploying predictive analytics are able to maximize the effectiveness of its staff and other resources, increasing public safety, and keeping bad guys off the street.
More about Crime Tech Solutionsblack version
Crime Tech Solutions is an Austin, TX based provider of crime and fraud analytics software for commercial and law enforcement groups. Our offerings include sophisticated Case Closed™ investigative case management and major case management, GangBuster™ gang intelligence software, powerful link analysis software, evidence management, mobile applications for law enforcement, comprehensive crime analytics with mapping and temporal reporting, and 28 CFR Part 23 compliant criminal intelligence database management systems.

Crime Tech Solutions’ continued growth fuels management team expansion

September 13, 2016 – (Leander, TX)  Crime Tech Solutions, a fast-growing provider of low cost crime fighting software and analytics today announced the appointment of Kevin Konczal as Vice President of Sales. The company created the position in response to rapid growth in market share for crime analysis and investigative case management software.
aaeaaqaaaaaaaaecaaaajdixztq5zgfkltliodctndi4ns05ztfjltzhowyxymjhmmu5maMr. Konczal is a seasoned start-up and marketing expert with over 30 years of diversified business management, marketing and start-up experience in information technology and consumer goods. Additionally, Konczal has over two decades of Public Safety service as a police officer, Deputy Sheriff and Special Agent.
Most recently, he held the position as a Regional Sales Manager for TriTech Software Systems, a leading provider of public safety software.
“Kevin is a seasoned executive with a combination of public service and information technology expertise”, said Crime Tech Solutions’ chief technology officer Keith Weigand. “The management team is looking forward to adding his leadership within the sales organization.”
In addition to his executive career, Konczal serves on several advisory boards, commissions and boards of directors.  He attended Oakland College studying Criminal Justice and completed the Dallas Police Academy. Notably, he was awarded the Police Commendation Award for saving the lives of fellow officers in a deadly force cblack versiononfrontation.
“The exciting thing about Crime Tech Solutions”, added Konczal “is their clear position as a fast-growing company dedicated to low price and high performance software for law enforcement.”
“I’m looking forward to working with a company that delivers true value to customers with comprehensive investigative case management software, sophisticated link analysis tools, criminal intelligence management software, and crime mapping technology that includes what I think are the industry’s best analytics and reporting capabilities”, he added.
Earlier this year, Crime Tech Solutions acquired Tennessee based Case Closed Software (www.caseclosedsoftware.com).
About Crime Tech Solutions
Crime Tech Solutions (www.crimetechsolutions.com) is a fast-growing U.S. based provider of low cost / high performance investigation software and crime analytics. The company proudly supports the International Association of Crime Analysts (www.iaca.net), International Association of Chiefs of Police (www.iacp.org), the National Sheriff’s Association (www.sheriffs.org), and the association of Law Enforcement Intelligence Units (www.leiu.org).
The company’s products include Case Closed investigative case management software, link and social network analytics, 28 CFR Part 23 compliant criminal intelligence management software, enterprise search for law enforcement, and crime analytics with mapping, reporting, and predictive policing.

Data continues to influence policing

Great article by Megan Favignano at New Press Now. Original article at http://www.newspressnow.com/news/local_news/data-continues-to-influence-policing/article_ef968ba2-389c-5289-b341-a9818ae231d7.html
A copy of the article follows:
5WA recent report questions how some police departments are using data to forecast future crimes.
The report examined how departments are utilizing predictive policing, a computer software that uses data to forecast where crime may happen, who may commit it and who could be potential victims.

Logan Koepke, an analyst who coauthored the report, said the handful of departments that use the software don’t appear to give patrol officers much guidance on what to do with the information provided.
“One problem we’ve seen is there is not a lot of direction from police departments or from vendors about what officers in the field should do once they look at a prediction,” Koepke said.
Upturn, an analysis organization out of Washington, D.C., that works with a variety of groups, published the report “Stuck in a Pattern” last month. “Predictive policing,” the report states, is a marketing term popularized by vendors who sell the software.
The group’s research showed areas that use the software often don’t engage the public in discussion about predictive policing and questioned whether or not departments who use it are measuring the impact the data-driven tool has on policing and crime rates.
AnalyticsHow police departments nationwide utilize crime statistics and the software available to patrol officers monitoring incidents has evolved a lot in the past couple decades, Sgt. Tracy Barton with the St. Joseph Police Department said. Barton started as a patrol officer 20 years ago. He said having software like police have today would have been useful.
“I was in District 7, which is the Midtown area. It would have been really cool to know where crime is occurring in District 7 and that I could look that up on a computer and have it at my fingertips where I could see it on an up-to-date basis,” Barton said.
In the past, crime analysts used physical maps and mathematical algorithms to do what software does instantly today. Barton, the St. Joseph Police Department’s crime analyst, uses software that takes into account crimes reported to police to show crime hot spots in the city. A map of those hot spots is available online. Officers, he said, have access to a more in-depth version of that hot spots map, which includes extra details about the area and the crimes occurring.
The hot spots approach St. Joseph police use is most helpful in preventing crime when a series of crimes occur or when there is a crime pattern in a given area, he said. St. Joseph’s small size, Barton added, poses an extra challenge.
Crime analytics Mapping Predicitive Policing
The St. Joseph Police Department has had its current software for just a few years. It doesn’t fit the definition of the predictive policing software Upturn outlines in the recent report. The software used locally depends on crime reports police receive. Predictive policing also looks at what types of business are located in an area, if repeat offenders live nearby and other information to predict where crimes may occur. Typically, according to the recent report, predictive policing takes one of two approaches, focusing either on place-based data or person-based data to make predictions.
Kevin Bryant, sociology and criminology professor at Benedictine College, said when people hear predictive policing described, they often think of the movie “Minority Report.” The software, he said, is nothing like in the movies.
“Predictive policing now has kind of morphed into better proactive methods that are based on prediction to some extent in forecasting risk,” Bryant said of how data-driven policing has changed over time. “But what we’ve learned through evaluation studies is that it’s really more important what the police do when they’re in a crime hot spot.”
Ba10ryant worked with the Shawnee, Kansas, Police Department on research that looked at what he calls “smart policing.” In his research and in other work he has read, Bryant said it’s important for police to have a high visibility in crime hot spots, for officers to make connections with the public and for them to avoid staying in crime hot spots for extended periods of time.
When police are in a hot spot for too long, public surveys show area residents feel like they are being picked on rather than protected, he said. Predictive policing takes into account businesses in a given area. Bryant said some types of facilities are at a higher risk of victimization and others can attract crime to an area.
“Knowing where bars, taverns, restaurants, gas stations, convenience stores are, we can actually use their locations as a means of forecasting where crime might emerge at a later date,” Bryant said. “Part of predictive policing is predicting who the risky offenders are and that can be controversial.”
Upturn’s report also explored an ongoing debate among criminologists on the impact of using crime reports when determining patrol.
“Criminologists have long emphasized that crime reports and other statistics gathered by the police are not an accurate record of the crime that happens in a community,” the report states.
Police statistics, Koepke said, reflect officer enforcement efforts, not just crime.
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The Name Game Fraud

  1. Hello-my-name-is1Posted by Douglas Wood, Editor. Alright everybody, let’s play a game. The name game!

“Shirley, Shirley bo Birley. Bonana fanna fo Firley. Fee fy mo Mirley. Shirley!” No, not THAT name game. (Admit it… you used to love singing the “Chuck” version, though.)
The name game I’m referring to is slightly more sinister, and relates to the criminal intent to deceive others for gain by slightly misrepresenting attributes in order to circumvent fraud detection techniques. Pretty much anywhere money, goods, or services are dispensed, folks play the name game.
Utilities, Insurance, Medicaid, retail, FEMA. You name it.
Several years ago, I helped a large online insurance provider determine the extent to which they were offering insurance policies to corporations and individuals with whom they specifically did not want to do business. Here’s what the insurer knew:

  1. They had standard application questions designed to both determine the insurance quote AND to ensure that they were not doing business with undesirables. These questions included things such as full name, address, telephone number, date of birth, etc… but also questions related to the insured property. “Do you live within a mile of a fire station?”, Does your home have smoke detectors?”, and “Is your house made of matchsticks?”
  2. On top of the questions, the insurer had a list of entities with whom the knew they did not want to do business for one reason or another. Perhaps Charlie Cheat had some previously questionable claims… he would have been on their list.

In order to circumvent the fraud prevention techniques, of course, the unscrupulous types figured out how to mislead the insurer just enough so that the policy was approved. Once approved, the car would immediately be stolen. The house would immediately burn down, etc.
The most common way by which the fraudsters misled the insurers was a combination of The Name Game and modifying answers until the screening system was fooled. Through a combination of investigative case management and link analysis software, I went back and looked at several months of historical data and found some amazing techniques used by the criminals. Specifically, I found one customer who made 19 separate online applications – each time changing just one attribute or answer slightly – until the policy was issued. Within a week of the policy issue, a claim was made. You can use your imagination to determine if it was a legitimate claim. 😀
This customer, Charlie Cheat (obviously not his real name), first used his real name, address, telephone number, and date of birth… and answered all of the screening questions honestly. Because he did not meet the criteria AND appeared on an internal watch list for having suspicious previous claims, his application was automatically denied. Then he had his wife, Cheri Cheat, complete the application in hopes that the system would see a different name and approve the policy. Thirdly, he modified his name to Charlie Cheat, Chuck E. Cheat, and so on. Still no go. His address went from 123 Fifth Street to 123-A 5th Street. You get the picture.
Then he began to modify answers to the screening questions. All of a sudden, he DID live within a mile of a fire station… and his house was NOT made of matchsticks… and was NOT located next door to a fireworks factory. After almost two dozen attempts, he was finally issued the policy under a slightly revised name, a tweak in his address, and some less-than-truthful answers on the screening page. By investing in powerful  investigative case management software with link analysis and fuzzy matching this insurer was able to dramatically decrease the number of policies issued to known fraudsters or otherwise ineligible entities.
Every time a new policy is applied for, the system analyzes the data against previous responses and internal watch lists in real time.  In other words, Charlie and Cheri just found it a lot more difficult to rip this insurer off. These same situations occur in other arenas, costing us millions annually in increased taxes and prices. So, what happened to the Cheats after singing the name game?
Let’s just say that after receiving a letter from the insurer, Charlie and Cheri started singing a different tune altogether.

Using Link Analysis to untangle fraud webs

Posted by Douglas Wood, Editor.
NOTE: This article originally appeared HERE by Jane Antonio. I think it’s a great read…
Link analysis has become an important technique for discovering hidden relationships involved in healthcare fraud. An excellent online source, FierceHealthPayer:AntiFraud, recently spoke to Vincent Boyd Bryant about the value of this tool for payer special investigations units.
A former biometric scientist for the U.S. Department of Defense, Bryant has 30 years of experience in law enforcement and intelligence analysis. He’s an internationally-experienced investigations and forensics expert who’s worked for a leading health insurer on government business fraud and abuse cases.
How does interactive link analysis help insurers prevent healthcare fraud? Can you share an example of how the tool works?

Boyd Bryant: Link analysis is most often used to piece together different kinds of data from multiple sources–to identify key players, connections between those players and patterns of behavior frequently missed. It can simplify an understanding of the level of involvement of individuals and criminal organizational hierarchies and can greatly simplify visualizing and communicating the operations of complex criminal enterprises.

One thing criminals do best is hide pots of money in different places. As a small criminal operation becomes successful, it will often expand its revenue streams through associated businesses. Link analysis is about trying to figure out where all those different baskets of revenue may be. Insurers are drowning in a sea of theft. Here’s where link analysis becomes beneficial. Once insurers discover a small basket of money lost to a criminal enterprise, then serious research needs to go into finding out who owns the company, who they’re associated with, what kinds of business they’re doing and if there are claims associated with it.
You may find a clinic, for example, connected to and working near a pharmacy, a medical equipment supplier, a home healthcare services provider and a construction company. Diving into those companies and what they do, you find that they’re serving older patients for whom multiple claims from many providers exist. The construction company may be building wheelchair ramps on homes. And you may find that the providers are claiming payment for dead people. Overall, using this tool requires significant curiosity and a willingness to look beyond the obvious.
Any investigation consists of aggregating facts, generating impressions and creating a theory about what happened. Then you work to confirm or disconfirm your theory. It’s important to have tools that let you take large masses of facts and visualize them in ways that cue you to look closer.
Let’s say you investigate a large medical practice and interview “Doctor Jones.” The day after the interview, you learn through link analysis that he transferred $11 million from his primary bank account to the Cayman Islands. And in looking at Dr. Jones’ phone records, you see he called six people, each of whom was the head of another individual practice on whose board Dr. Jones sits. Now the investigation expands, since the timing of those phone calls was contemporaneous to the money taking flight.
Why are tight clusters of similar entities possible indicators of fraud, waste or abuse?
Bryant: When you find a business engaged in dishonest practices and see its different relationships with providers working out of the same building, this gives rise to reasonable suspicion. The case merits a closer look. Examining claims and talking to members served by those companies will give you an indication of how legitimate the operation is.
What are the advantages of link analysis to payer special investigation units, and how are SIUs using its results?
Bryant:  Link analysis can define relationships through data insurers haven’t always had, data that traditionally belonged to law enforcement.
Link analysis results in a visual reference that can take many forms: It can look like a family tree, an organizational chart or a time line. This reference helps investigators assess large masses of data for clustering and helps them arrive at a conclusion more rapidly.

Using link analysis, an investigator can dump in large amounts of data–such as patient lists from multiple practices–and see who’s serving the same patient. This can identify those who doctor shop for pain medication, for example. Link analysis can chart where this person was and when, showing the total amount of medication prescribed and giving you an idea of how the person is operating.
What types of data does link analysis integrate?
Bryant: Any type of data that can be sorted and tied together can be loaded into the tool. Examples include telephone records, addresses, vehicle information, corporate records that list individuals serving on boards and banking and financial information. Larger supporting documents can be loaded and linked to the charts, making cases easier to present to a jury.
Linked analysis can pull in data from state government agencies, county tax records or police records from state departments of correction and make those available in one bucket. In most cases, this is more efficient than the hours of labor needed to dig up these types of public records through site visits.
Is there anything else payers should know about link analysis that wasn’t covered in the above questions?
Bryant: The critical thing is remembering that you don’t know what you don’t know. If a provider or member is stealing from the plan in what looks like dribs and drabs, insurers may never discover the true extent of the losses. But if–as a part of any fraud allegation that arises–you look at what and who is associated with the subject of the complaint, what started as a $100,000 questionable claims allegation can expose millions of dollars in inappropriate billings spread across different entities.