Mohamed Fathi Email and Phone Number

Developed a Ministry-recognized intelligent insurance system, an automated Excel-based tool designed to review medical claims and integrate seamlessly with any insurance platform to detect potential fraud, waste, and abuse (FWA) flagged by the DHA. The tool captures violations including but not limited to exceeded quantities, frequent billing, unbundling, upcoding, billing duplicates, medical exclusions, age-based restrictions, and ICD Exclude1, processing 20,000 claims in less than a minute. This tool significantly enhanced staff efficiency, claims accuracy, reduced denials, and decreased processing time by 95%.