Healthcare Fraud Shield (“HCFS”) is a leading provider of Fraud, Waste and Abuse (“FWA”) detection software to healthcare payers. Founded in 2011, the company is one of the fastest growing providers of FWA solutions in the healthcare industry. HCFS offers a next-generation SaaS platform that uses proprietary data, artificial intelligence, rules and algorithms to enable payers to identify FWA claims, driving meaningful cost savings and a high ROI for customers. In addition, the platform provides workflow and productivity tools that significantly enhance payer efficiency. The platform is fully integrated, addressing the entire range of pre-payment and post-payment workflows with a combined view of both medical and pharmacy claims. HCFS is led by a management team with notable experience building successful fraud detection businesses in other verticals.
Charlesbank’s Technology Opportunities Fund invested in HCFS in December 2020, taking a controlling interest in the company with the balance owned by management. The investment will enable continued growth and accelerate existing investments in proprietary analytics, artificial intelligence, new products and customer service. Prior to this investment, Healthcare Fraud Shield had not taken any institutional equity capital.