Health and P/C Insurers Spend Billions Overpaying Medical and Injury
Claims; ClaimCatcher Lets Insurers Share Records, ID Overpayments,
RICHMOND, VA -- (Marketwire) -- 11/13/12 -- Health and
property/casualty insurers overpay injured people an estimated $15
billion a year because each sector of the industry lacks information
about claimants that only the other side has, according to Stephen
Ambrose, CEO of ICEX, an insurance information-services company.
To plug that gap, ICEX has developed ClaimCatcher(R), the industry's
first cross-claims data exchange designed to reduce overpayments for
medical and injury claims.
"For the first time, P/C insurers will be able to tap into an injured
claimant's medical claims history from health insurers to verify
preexisting injuries related to the current claim," Ambrose said.
Separately, health insurers will be able to find out when their
members have filed injury claims with P/C insurers. The health
insurer can then subrogate against the member.
ClaimCatcher complies with HIPAA, NAIC model regulations and the most
stringent state insurance laws on privacy, claims and data. The
technology will be used by P/C insurers, health insurers, Medicaid,
self-insured employers and workers' compensation carriers.
Only 0.5% to 1.0% of all paid medical claims result in subrogation
recoveries, according to CIGNA. Relying on predictive analytics and
form letters, Medicaid and commercial health plans recover less than
$2 billion annually, perhaps only 25 percent of what's available,
Because ClaimCatcher doesn't rely on claimants to personally validate
their involvement in a claim, widespread adoption of the technology
could eventually boost recoveries to nearly $9 billion, Ambrose said.
Almost 39 million injury claims are filed yearly, and payouts from
all P/C insurers total nearly $180 billion a year, according to A.M.
Best. Using ClaimCatcher's HIPAA-compliant process, P/C insurers can
request and match up prior medical claims related to the claimant's
current injuries. Ambrose believes that better identification of
preexisting conditions can save P/C insurers $7 billion and slash
overall claims costs by nearly 4%.
"Overpaying claims is unfair. It costs insurers, employers, taxpayers
ds a fortune. Providing a new level of transparency will
make claims management far more accurate and fair," he said.
ClaimCatcher is expected to become available during the second
quarter of 2013. ICEX is currently looking for the right strategic
partner to help deliver its proprietary technology to the industry.
More information about ClaimCatcher and strategic-partner
opportunities is available at www.claimcatcher.com or by writing
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