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Owners

Goods & Services

Fraud detection services in the field of health care insurance

Financial management; insurance subrogation; predictive modeling, namely, financial forecasting; insurance claims case management; catastrophic insurance claim management; bill payment services featuring bill review and re-pricing; insurance claims case management for neonatal care; insurance claims case management for disease treatment

Physician review services, namely, tracking and monitoring insurance compliance; physician referral services; administration of a program for enabling participants to obtain discounts on services, namely, providing members access to expanded specialty care networks such as organ transplants, cancer management and neonatal management in hospitals outside their primary healthcare network at pre-negotiated rates; promoting the goods and services of others by means of a preferred vendor program featuring an out of network (OON) wrap around, namely, providing members access to larger healthcare networks to cover members who seek care outside their primary healthcare network; business risk management in the field of health care, namely, predicting, managing and minimizing potential losses