Health Care Claims Payment Cost Reduction Analysis

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A Verisk Health Company

CLINICALLY VALIDATED FRAUD, ABUSE AND OVERPAYMENT PREVENTION >


CRA

Fraud, abuse & overpayment 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


Let us quantify your annual fraud, abuse and overpayment savings and identify key areas of risk and waste.

“HCI has prevented the payment of over $5 million in inappropriate charges.” – Michael De Chellis Operating Engineers Trust Funds Inc.

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.

$311.1 $293.1 $277.0

(In Billions)

$262.4

$78.7 2010

$83.1 2011

$87.9 2012

$93.3

2013

Results > Measure PMPM savings projections > Align areas of risk with tailored solutions > Understand fraud and abuse program ROI 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.

www.hcinsight.com


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


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