Health Care
Three percent of America’s $1.7 trillion annual health care expenditure—an astounding $51 billion—is lost to fraud and overcharging, according to the NHCAA. What’s more, this costly abuse is growing at a rate of over 5% per year. We offer comprehensive verification, validation and authentication tools in order to help you mitigate risk.
We offer comprehensive verification, validation and authentication tools in order to help health insurers combat fraud and protect their organizations.
Verify the identities of providers and suppliers
Minimize risk and prevent improper payments by verifying the identities of health plan members, providers, and suppliers. InstantID® searches both business and consumer records to verify such essential data as name, address, and social security or Federal Identification number, and it alerts you to indicators of identity theft or fraud.
Order medical records
LexisNexis® Medical Records Retrieval offers a fast, convenient way to order records and verify your customers’ medical histories. Our secure, web based interface allows you to request orders and to view the status of each request in real-time, 24 hours a day, seven days a week. We also offer additional research services whenever you suspect that a customer has omitted crucial information.
Improve your collections and subrogation efforts
Recover assets and settlements and increase revenue with LexisNexis® Collections Management solutions. This powerful suite of tools helps you investigate debtors and uncover any potential third-party liability for claims payment, whether partial or in full.
Prevent and investigate fraud
Reduce the risk of health care fraud and abuse with Accurint® for Health Care, a powerful tool that helps verify and validate the professional licenses of health care providers nationwide. Such in-depth information as board certifications, DEA licensing, legal standing, criminal records, and licensing entities are available. Accurint’s sophisticated linking technology can also reveal undisclosed relationships between patients, providers, and medical facilities.
In order to allow National Health Care Anti-Fraud Association (NHCAA) members to collaborate with one another and share critical information on suspected fraud and abuse cases, LexisNexis® Risk & Information Analytics Group has re-engineered the Special Investigation Resource and Intelligence System, or SIRIS. SIRIS data includes useful descriptions of health care fraud schemes and trends as well as searchable information on individual cases.
Find new customers
We offer a variety of direct marketing solutions to help you find new customers and expand your business. Targeted Consumer Lists provides you with accurate, relevant consumer data in order to help you locate the very best prospects. With Data Enhancement, you’ll learn more about your current customers, identify look-alikes to your best responders, and generate broader and more successful marketing campaigns. And Data Hygiene can help you optimize your address files, detect name changes, and create a complete, single customer view for up- and cross-selling.
Screen prospective employees and business partners
LexisNexis® Background Screening Solutions help you limit your liabilities while remaining fully complaint with federal and state privacy regulations, as well as FCRA requirements. LexisNexis® Applicant Screening offers comprehensive verification and analysis of high risk elements like education, financial history, and legal standing for both individual applicants and corporate vendors. Express Screening is designed for organizations that need fast, easy, and legally compliant pre-employment screening or tenant applicant background checks. You can evaluate the risks associated with prospective business partners with Vendor Screening, a cost-effective, easy-to-use tool that evaluates businesses’ financial history, legal standing, and performance records.
How can we help your company? For more information about our solutions call (800) 869-0751 or email us now
