LexisNexis® Presents How to Detect and Prevent Health Care Fraud Schemes Using Fraud Detection Analytics at AHIP Institute

  LexisNexis® Presents How to Detect and Prevent Health Care Fraud Schemes
  Using Fraud Detection Analytics at AHIP Institute 2013

 Will Address Payer Health Care Fraud and Identity Risk in Implementation of
                        ACA, Launch New Solution Suite

AHIP Institute 2013

Business Wire

ATLANTA -- June 12, 2013

LexisNexis^® Risk Solutions today announced its latest suite of anti-fraud and
identity management solutions to help health care payers reduce risks
associated with wasteful spending, manual operational processes and lack of
transparency across member, claims and provider data.

“With rising medical identity theft and millions of soon-to-be insureds,
health care payers are challenged with helping to protect their members and
also reduce wasteful administrative spending to meet medical loss ratio
requirements,” said Harry Jordan, SVP and GM, Health Care, LexisNexis.
“LexisNexis has a unique combination of data, analytics and technology to link
unexpected information sets enabling payers to verify patients and providers
are who they say they are, address fraud, waste and abuse from detection
through recovery and meet provisions of the ACA and quality reporting
standards.”

The suite of LexisNexis health care solutions focus on provider, member and
claims management, enabling payers to:

  *Maximize the dollars directed to improving the coordination and quality of
    care delivered by identifying areas of financial loss and reducing
    unnecessary administrative costs;
  *Positively impact patient safety, reduce reputational risks, and avoid
    legal threats by identifying sources of risk; and
  *Accurately identify potential fraudulent activities among providers,
    members and claims through comprehensive identity and claims analytics
    tools.

With more consumers entering the health care system and changes like ICD-10,
the opportunity for fraudulent activity becomes greater. For payers, the right
combination and application of analytics and data sources can improve
prevention efforts, reduce associated costs, and improve member satisfaction
by ensuring that only trusted providers are in a network. LexisNexis experts
Ken Cunningham, Vice President, Analytics, and Russell Streur, Director,
Fraud, Waste & Abuse Analytics, present real world applications in the AHIP
Institute session, “Maintaining the Integrity of Provider Networks: Detecting
Emerging Fraud Schemes with Analytics,” on Thursday, June 13 from 3:55 p.m. -
4:45 p.m.

About LexisNexis Risk Solutions

LexisNexis Risk Solutions (www.lexisnexis.com/risk/) is a leader in providing
essential information that helps customers across industries and government
predict, assess and manage risk. Combining cutting-edge technology, unique
data and advanced analytics, LexisNexis Risk Solutions provides products and
services that address evolving client needs in the risk sector while upholding
the highest standards of security and privacy. LexisNexis Risk Solutions is
part of Reed Elsevier, a leading global provider of professional information
solutions across a number of sectors. Our health care solutions assist payers,
providers and integrators with ensuring appropriate access to health care data
and programs, enhancing disease management contact ratios, improving
operational processes, and proactively combating fraud, waste and abuse across
the continuum.

Contact:

LexisNexis
Regina Haas, +1-678-694-3569
regina.haas@lexisnexis.com
 
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