A Verisk Health Company
CLINICALLY VALIDATED FRAUD, ABUSE AND OVERPAYMENT PREVENTION >
Fraud, abuse & overpayment prevention for vision claims >
Clinicians detect your payment blind spots. Let our
Prevent Fraud | Improve Accuracy | Reduce Costs
Improve your claims payment accuracy, detect fraudulent providers and minimize your professional claims costs.
“HCI goes to bat for the client and the patient to be sure the provider is being fair and just.” – Orlo L. “Spike” Dietrich The Ansley Group
Prevent Fraud | Improve Accuracy | Reduce Costs
THE
THE
Problem
Solution
Fraud Stats 3% – 10% of America’s outlay for other health care services (including vision care) is lost to fraud and abuse.
$8.4 $8.0 $7.5
(In Billions)
$7.2
$2.1 2010
$2.3 2011
$2.4
2012
$2.5
2013
Results > Reduce annual claims expenditures > Improve vision claims payment accuracy > Increase overall profitability Features > Prepayment analysis on 100% of vision claims > Clinical review on all suspect claims and providers > Code Validator Pro® — Rules-based editing > Fraud Finder Pro® — Provider profiling and scoring > Highly customizable rules and parameters > Real-time claims processing and ad hoc reporting > Clinically-driven appeals support and response > Daily notification of suspect providers and claims > Easy to use web-based application > Full-service vision claims cost-containment solution
Fraud Projections for Other Health Services 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