AiDA Launches Fraud-Waste-Abuse Detection Solution SMART-FRAUD with Support from AWS SaaS Factory
By Dhammika Sriyananda, Sr Partner Solutions Architect – AWS
AiDA Technologies, in partnership with AWS SaaS Factory, launched SMART-FRAUD, an artificial intelligence (AI)-powered, multi-tenant software-as-a-service (SaaS) solution to reduce fraud, waste, and abuse (FWA) in the health insurance industry.
AiDA Technologies is a leading Singapore Fintech and Insurtech SaaS provider of AI and machine learning (ML) solutions, empowering Asia’s top insurers and banks. AiDA works with more than 50% of Shield health insurers in Singapore and has business operations across five other countries in APAC.
AiDA built and launched its SaaS product with the goal of increasing business agility, operational efficiencies, and economies of scale. SMART-FRAUD uses AI to monitor health insurance claims to unearth cases of irregular behaviors such as claims fraud, over-charging, over-servicing, and other unusual behaviors.
“AWS SaaS Factory helped our team with prescriptive guidance with the right AWS services to build our SaaS solution fast. After the launch in Singapore, we were able to scale our services to four more countries within a couple of months” says Dr. Geok Leng Tan, Founder and CEO at AiDA Technologies.
Why SMART-FRUAD is Important as a SaaS Solution
AiDA Technologies understands this solution would enable the expansion of its business into new market segments and geographic regions. Also, the company identifies that a successful SaaS transformation improves the synergy between the technical, business, and operational aspects of the teams, and overall cultural transformation of the organization.
AWS SaaS Factory provided the necessary technical and business prescriptive guidance throughout the journey of building AiDA’s SaaS solution, launching on AWS, and scaling it to multiple regions with reduced time-to-market.
The solution is empowered with the following key features for its customers:
- Detect country-level fraud claims across multiple dimensions, features, and fine-grained parameters.
- Detect and mark high fraud entities (claimants, hospitals, doctors) for unusual or outlier claims.
- Provide detailed and data-driven insights for reporting and corrective actions.
Q&A with AiDA Technologies
We recently spoke with Dr. Geok Leng Tan, Founder and CEO, and Mousumi Milly Bashir, Head of Products, at AiDA Technologies to learn more about the SMART-FRAUD SaaS, the value it brings to the customers, and key lessons learned building it on AWS.
AWS SaaS Factory: Could you share a bit about your background and role at AiDA Technologies?
Dr. Geok Leng Tan: I’m an industry veteran with over 30 years of experience, with a wide variety of prior roles in the industry and government, including product development at Motorola, techno-business consulting at Scientific Generics in Cambridge, UK, CTO at the Infocomm Development Authority of Singapore (IDA), and Executive Director at the Institute for Infocomm Research (I2R). Currently, I am running AiDA Technologies as the CEO.
Milly Bashir: I’m an IT professional with 20+ years of experience leading consulting engagements for technology innovation and digital transformation in different markets and industries. I have helped organizations to execute their strategy by leveraging my experience with business process improvement and constant enthusiasm for new technologies. As Head of Products, I have helped AiDA Technologies develop and implement new product initiatives, pre-sales efforts, and marketing strategies for brand awareness.
AWS SaaS Factory: What products and solutions has AiDA Technologies built on AWS?
Dr. Geok Leng Tan: SMART-FRAUD is our first native AI service as a SaaS solution. We have also built a Rapid Pilot Service on AWS. This is a simple cloud service for insurers to rapidly evaluate the performance and business benefits of AiDA AI/ML services using their own data. Both clients and data scientists can manage and conduct pilots under one platform. AiDA is in the process of rearchitecting other AI/ML insurance services it deploys in customer data centers, such as SMART-CLAIMS and SMART-AGENTS, to make them available as a service on the AWS Cloud.
AWS SaaS Factory: Who are your customers and what are the benefits of using the new SMART-FRAUD SaaS solution?
Milly Bashir: SMART-FRAUD is a data-driven service trained with over 20 million claims. It’s able to flag potential FWA cases and highly descriptive details as to why the claim has been identified as an outlier to enable the insurer to take corrective action. The most important advantage of SMART-FRAUD is the holistic country-level visibility to FWA based on key risk indicators.
In general, an insurance company only has visibility to its own data. Hence, their fraud detection capabilities would be constrained by this dataset. However, by using AiDA’s SMART-FRAUD service, the company would be able access a fraud database that is much more holistic and can detect fraud modalities arising from providers, doctors, and claims at the country level without the need of any personal identification information.
We have three main target customers who can benefit from our SMART-FRAUD service:
- Health insurers trying to keep medical costs under control via rejecting outlier claims and trying to perform provider network management.
- National health agencies trying to understand the nature of health claims by disease-types and by cohorts.
- Third-party administrators trying to detect potential FWA in claims processing.
Currently, our SMART-FRAUD service is available in Singapore, Hong Kong, Malaysia, Thailand, and Indonesia.
AWS SaaS Factory: Can you walk us through the SaaS architecture and the key AWS services used?
Dr. Geok Leng Tan: Using AWS managed services, we were able to build a solution that adhered to data and privacy requirements while simultaneously focusing on latency, throughput, availability, elasticity, and data-modelling requirements. The solution has a common framework, deployed in all regions, that will enable us to innovate rapidly on new services and get them to market fast.
The current architecture uses the following core AWS services:
- Amazon Elastic Container Service – Host core, multi-tenanted business services.
- AWS Fargate – Run containers without overload of managing servers or clusters.
- AWS Lambda – Host workload for real-time fraud scoring calculations, and host AI/ML workloads with Lambda container images.
- AWS Step Functions – Manage and orchestrate workflows across business services.
- Amazon Relational Database Service – Manage AiDA’s scoring data at scale.
- Amazon DynamoDB – Manage tenant-specific business data at scale.
- Amazon Cognito – Centralize the identity data of tenant users and manage SaaS identities.
- AWS Identity and Access Management – Securely manage identities and access to other AWS services and resources.
- AWS Secrets Manager – Manage the lifecycle of database credentials, security keys, and secrets.
- Amazon Simple Storage Service – Manage tenant-specific object data at scale.
- Amazon CloudWatch – Collect, monitor and analyze the data and metrics of the application
- Amazon API Gateway – Maintain and monitor API endpoints at scale and implement tenant-wise API metering and usage plans.
Figure 1 – AiDA’s SMART-FRAUD SaaS architecture.
AWS SaaS Factory: What were the biggest challenges in your transformation to a SaaS delivery model?
Dr. Geok Leng Tan: I would say the mindset change towards the SaaS delivery model, and for building cloud-native solutions on AWS. Other than building a SaaS with multi-tenancy best practices, it was challenging to model a solution that works with country-wide regulatory, data residency, and sovereignty requirements. That was important for us as we wanted to launch the SaaS solution to multiple countries.
AWS SaaS Factory: Describe how the SaaS Factory team supported in AiDA’s SaaS transformation journey?
Dr. Geok Leng Tan: It’s been amazing the prescriptive guidance and deep support given by SaaS Factory in our journey. There’s so much good content delivered and good advice that we could use. It was a very comprehensive agenda that SaaS Factory provided, covering architectural as well as business aspects. On the technical front, we have embedded quite a number of the concepts such as multi-tenancy and infrastructure monitoring into our SaaS service.
Milly Bashir: SMART-FRAUD is our first cloud-native service on AWS and it was a learning journey for our multi-cultural team. SaaS Factory facilitated multiple remote workshops, with one-on-one deep dive meetings as necessary. In the business and technical workshops, the SaaS Factory experts worked through our go-to-market and architectural goals, helping us understand the trade-offs for the decisions we are making.
We found AWS SaaS Factory put a significant amount of thought into multi-tenant SaaS models, both from the compute as well as the data perspective, which was important to us. It gave us a framework to work through our thought processes in where we needed to go, and how to get there.
This work ultimately laid the foundations for our multi-region service, which was necessary to set us up for global growth. The journey was quite smooth and our multi-country resources were able to uniformly collaborate using the best practice guidelines.
AWS SaaS Factory: What advice would you share to other software providers who navigate to a SaaS delivery model?
Dr. Geok Leng Tan: In SaaS, both technical and business aspects are very important. There is a difference in how you sell a SaaS solution, and there are certain benefits and constraints you should be aware of. If you are not mindful of these, you may not be able to get the full benefit of going SaaS. The full power of SaaS is derived when you have one product that everybody uses. It enables rapid optimization of your solution, and you can do so with minimum resources.
Milly Bashir: When dealing with multiple regions and multi-tenancy, look at your data and privacy regulations to build and deploy the best-fit architecture. The right type of isolation will enable you to evolve as you scale. Take advantage of the wealth of knowledge in the AWS best practices documentation and use cases. Join AWS SaaS Factory to make the journey smoother and accelerated. Another avenue to explore is AWS managed services that can solve most common challenges.
About AWS SaaS Factory
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AiDA Technologies – AWS Partner Spotlight
AiDA Technologies is a specialist provider of AI/ML solutions for insurance companies with solutions for claims automation, fraud detection and revenue enhancement.
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