At HLTH, finHealth's Analytics and Error-Detection Solution Helps Self-Insured Organizations Reduce, Eliminate Profit-Sapping Health Expenditures
At May 6 HLTH event, finHealth attacks wasteful healthcare spend
LAS VEGAS, May 6, 2018 (Newswire.com) - finHealth plans to continue pioneering efforts to decrease and eliminate wasteful healthcare spend-reducing profits at many self-insured organizations, demonstrating a powerful real-time web-based error-detection program.
At the HLTH’s Future of Healthcare Event opening here today, a team of finHealth executives will demystify any notion that controlling healthcare overpayments is elusive and cannot be easily contained or eliminated. On the conference floor, finHealth will be demonstrating how its Navigator solution identifies errors to control wasteful healthcare spend.
“At this conference, the simple multimillion-dollar question that frustrates every self-insured company is: How do I know if my carrier pays healthcare claims correctly?” said Jim Arnold, finHealth founder and chief executive officer. “In other words, what are you currently doing to effectively improve profitability by simplifying and controlling your healthcare claim spend?"
At this conference, the simple multimillion-dollar question that frustrates every self-insured company is: How do I know if my carrier pays healthcare claims correctly? In other words, what are you currently doing to effectively improve profitability by simplifying and controlling your healthcare claim spend?
At HLTH, Arnold and his team will inform and educate prospects on how finHealth’s Navigator deploys powerful proprietary algorithms that quickly identify errors in the billing of healthcare claims.
“finHealth's Navigator application brings unsurpassed transparency to all claim payment transactions in real time, delivering powerful data analytics that will help reduce healthcare costs and promote healthy outcomes for employees,” Arnold said.
Types of errors identified include claims paid without coverage (eligibility), duplicate billings, nonconformance with coding standards and medically unlikely costs due to age/gender conflicts and incorrect units billed.
Additionally, the program identifies billings far in excess of market value, up-coding on claims, potential fraudulent charges as well as the huge cost variations between providers for similar medical procedures within the same geographic area with no correlation to the quality of care.
The waste-reduction narrative revolves around the federal government annual error rate estimates of more than nine percent on healthcare claims. Self-insured companies' error rates can actually be significantly higher due to the number of errors made by third-party administrators.
Arnold said finHealth's recognized audit methodologies coupled with its analytic engine can resolve discrepancies regarding historical payments already made.
With the program, the self-insured company retrieves its historical data, finHealth processes the data through its application and notifies the client's third-party administrator (with the client's support and awareness) of the errors made.
"We work together with our customers and their third-party administrators to ensure that our clients get back the credits in cases of excessively billed claims and overpayments. It is a common occurrence for organizations depending on TPAs to fail to identify hospitals or healthcare providers offering the best affordable treatment.”
Based in Charleston, South Carolina, finHealth provides real-time, analytics and error-detection solutions to identify and safeguard healthcare dollars for self-insured organizations.
Jim Arnold (mobile 336-314-9955)