General Dynamics Information Technology's ViPS® and LexisNexis® Risk Solutions Enter into Agreement to Deliver Innovative Anti-Fraud Technologies for Health Care Payers
General Dynamics Information Technology's ViPS®, part of its Health IT Solutions business sector, and LexisNexis® Risk Solutions have entered into an agreement to integrate LexisNexis' data, technology, analytics and risk-based solutions with General Dynamics' STARSSolutions anti-fraud product suite. By combining the business knowledge and technologies of these two companies, customers will now have access to a 360° risk-scoring technique for discovering, quantifying and prioritizing instances of fraud, waste and abuse in public and private health care programs.
Challenge: Health care fraud continues to be a significant burden. Industry reports estimate losses in the United States between $60 and $200 billion per year from fraud, waste and abuse. As a result, risk control and overpayment prevention/recovery are core components of health care reform efforts. Health care payers need to find new and innovative ways to combat increased financial risk and regulatory scrutiny. And as identify theft and organized crime continues to increase, healthcare payers need next-generation advanced detection capabilities.
Solution: STARSSolutions is a market-leading suite of tools for lead generation, in-depth data analysis and comprehensive case management. It includes integrated investigative components, sophisticated statistical aggregations, industry reference data, multi-dimensional scoring methodologies and a deep metadata foundation..
LexisNexis Risk Solutions' health care data and analytic solutions enhance STARSSolutions with predictive analytics, unique data sources and best-in-class linking technologies.
The joint offering:
- Provides a multi-layered fraud risk control environment including pre- and post-payment detection;
- Reduces costs associated with claims that have been filed erroneously or fraudulently;
- Delivers streamlined and automated fraud detection with robust built-in intelligence;
- Increases recoveries per investigator; and
- Speeds time to financial recovery through enhanced operational efficiencies.
LexisNexis Risk Solutions' health care solutions deliver information-rich workflow solutions to payors, providers and IT integrators that leverage advanced analytics to enhance patient care, improve operational outcomes and proactively reduce waste across the healthcare continuum.
LexisNexis Risk Solutions' health care solutions help commercial payors, public sector agencies, claims processing vendors and investigative agencies enhance their ability to combat health care fraud, waste and abuse by leveraging capabilities in the areas of predictive modeling, pre- and post-payment analytics and other investigative tools. As a result, health care organizations can implement an appropriate fraud risk control environment across the payment workflow utilizing a multi-layered approach to proactively identify and prevent fraud, leading to cost savings and enhanced operational efficiency.
General Dynamics Information Technology
703. 246. 0525
LexisNexis Risk Solutions