Payment integrity solutions that begin and end with you saving. Pay Right. Save Money.
Preventing fraud, waste and abuse with the Clinical Touch. HealthCare Insight | A Division of Verisk Health
Cost Reduction Analysis
SM
Fraud, waste & abuse savings analysis for claims payors >
Boost Your Bottom line And We’ll Prove It Free We Can
Of Charge.
Identify Fraud | Expose Risk | Quantify Savings
Cost Reduction Analysis
SM
Let us quantify your annual fraud, abuse and overpayment savings and identify key areas of risk and waste.
The Nucleus Dashboard allows you to personalize widgets, like the “Savings Opportunities by Service� so you can work smarter and save more.
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Identify Fraud | Expose Risk | Quantify Savings
THE
THE
Problem
Solution
Fraud Stats 3% – 10% of the nation’s annual health care outlay is lost to fraud. By 2013, costs could eclipse $300 billion.
Results >> Measure PMPM savings projections >> Align areas of risk with tailored solutions >> Understand fraud and abuse program ROI
$311.1 $293.1 $277.0
(In Billions)
$262.4 $87.9
$93.3
$83.1 $78.7 2010
2011
2012
2013
Features >> Comprehensive analysis on 24 months of data >> Analysis by cutting-edge software systems >> Identification of overpaid claims and dollars >> Clinical review on a subset of suspect claims >> Detection of questionable provider activity >> Discovery of risk areas and vulnerabilities >> Detailed web and hard-copy reporting >> Analysis findings over 95% accurate >> Results in just 4–6 weeks after receipt of data >> Explanation and onsite presentation of findings
US health care fraud projections for 2010 – 2013 / 3 – 10% loss
10% Loss 3% Loss
Next Steps Contact us for a complimentary Cost Reduction Analysis. Call 1.877.619.5557 or email info@hcinsight.com today.
“HCI has prevented the payment of over $5 million in inappropriate charges.” – Michael De Chellis Operating Engineers Trust Funds Inc. www.hcinsight.com
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Why you’ll
Like Us.
CLINICAL REVIEW BY MDs, RNs & DDS’ >
Detailed ad-hoc Reporting >
PREPAYMENT SaaS SOLUTION >
Appeals Support & Response >
TOTAL Payor CUSTOMIZATION >
IMMEDIATE REALIZATION OF ROI >
Real-Time Claims Processing >
Solutions for all Payor Types >
memberships & Accreditations
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Prevent Fraud | Improve Accuracy | Reduce Costs
how to P
Phone
877.619.5557
S
F
Contact Us. Fax
801.285.5801
Connect With HCI
Twitter | Facebook
Linkedin | YouTube
M
E
info@hcinsight.com
R
W
Web
www.hcinsight.com
HCI Fraud Resources
www.profilermag.com www.stophealthcarefraud.com
HealthCare Insight 10897 S. River Front Parkway Suite 200 South Jordan, UT 84095
© 2010 HealthCare Insight – A Verisk Health Company. HealthCare Insight, PhysicianClaim Insight, DentalClaim Insight, FacilityClaim Insight, PharmaClaim Insight VisionClaim Insight, Code Validator Pro and Fraud Finder Pro are registered service marks and trademarks of HealthCare Insight. All other product or corporate names are trademarks or registered trademarks of their respective companies. Fraud loss figures based on Centers for Medicare & Medicaid Services (CMS) spending projections and National Health Care Anti-Fraud Association (NHCAA) loss estimates.
HealthCare Insight 10897 S. River Front Parkway Suite 200 South Jordan, UT 84095
Phone 877.619.5557 Email info@hcinsight.com Web www.hcinsight.com