HEALTHDATAINSIGHTS

Owner

Goods & Services

Software as a service (SAAS) applications to identify and recoup improper payments to healthcare providers; Software as a service (SAAS) applications and data mining for the purpose of providing health plans with information on healthcare pricing and quality; Software as a service (SAAS) applications and data mining for the purpose of providing health plans with financial, operational, and productivity information; Software as a service (SAAS) applications and data mining for the purpose of providing health plans with clinical information to identify opportunities to reduce costs and improve quality

Downloadable computer software applications to identify and recoup improper payments to healthcare providers; Downloadable computer software applications for the purpose of providing health plans with information on healthcare pricing and quality; Downloadable computer software applications for the purpose of providing health plans with financial, operational, and productivity information; Downloadable computer software applications for the purpose of providing health plans with clinical information to identify opportunities to reduce costs and improve quality for health plan members

Health care cost containment services, namely, identification for health plans of fraud, waste, abuse, errors and overpayments, providing information and analytics for the purposes of providing health plans with financial, operational, and productivity information, providing information and analytics for the purposes of providing health plans with clinical information to identify opportunities to reduce costs and improve quality, payment integrity services for private and government healthcare payers, review of healthcare claims to ensure appropriate payment and identify improper payments, review of medical records against healthcare claims to identify improper payments, automated review of medical records to identify improper payments, review of pharmacy claims to identify improper payments, onsite hospital reviews of medical records to identify improper payments, coordination of benefits services to determine third party liability for healthcare claims paid by private and government payers, and recovery of healthcare dollars paid inappropriately by private and government payers

Insurance services, namely, provision of health insurance information to private and government healthcare payers to ensure appropriate payment of healthcare claims