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The Importance Of Allegation Inferral Systems

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Integrating the allegation referral data into AFES will enhance our ability to identify interrelated claims and high-risk transactions across our programs. It will also modernize workflow capabilities and allow OIG to conduct more efficient inquiries and investigations of possible fraud. Integrating the ARIS data into AFES will provide more robust data to enhance our models quickly and make data-driven anti-fraud decisions. The capabilities of the ARIS will better position SSA to comply with federal government wide anti-fraud mandates for federal agencies.

ARIS will allow users to view status of their referrals from initial submission through outcome of referrals. The user interface will support the search of allegations by specific …show more content…

D. Functions for the To-Be Process

ARIS will serve as and support the following functions and tasks: • Allegation initiation, at the data entry point to submit referral, the system requests the type allegation and other basic information required for any allegation type.

• Cancel the allegation at any point prior to confirmation.

• Retract an allegation referral in instances where fraud is no longer suspected.

• Capture data that a user enters into the portal, it will also store allegation images and content, linked by relationship/characteristics to eliminate overlap and duplicate referrals (workflow management), catalog allegation development chronologically, and sequentially track allegation movements (allegation file management).

• Search for allegations by specific content.

• User may request to subscribe or unsubscribe to receive status of submitted allegations.

• The allegation and incident referral management system will collect provided data to feed analytics, reporting, operational, and analysis functions in AFES and enterprise Business Intelligence (BI) tools. • A dashboard mechanism, based on the user’s role to communicate pertinent referral information or key performance indicators (KPIs) to the user; grouping the KPIs logically to present

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