|By Business Wire||
|April 28, 2014 08:45 AM EDT||
Truven Health AnalyticsTM, a leading provider of healthcare analytics and data solutions and services, today announced the acquisition of Fortel Analytics’™ healthcare fraud technology. The acquisition gives Truven Health exclusive access to a breakthrough suite of predictive solutions, analysis methods and analytic technology designed to quickly identify suspicious patterns in healthcare insurance claims data before claims are ever paid.
Developed by Allen Jost, Ph.D., a renowned pioneer in early fraud detection and prevention, Fortel’s patent-pending predictive analytics quickly scour vast insurance claims data sets for statistical anomalies that are consistent with patterns of fraud and abuse. Claims are then flagged by the system for further investigation prior to payment. By pairing these industry-leading Big Data analytics capabilities with its robust collection of payment integrity solutions, Truven Health Analytics is positioned to offer a more powerful combination of pre- and post-payment fraud and abuse prevention solutions specifically tuned for healthcare.
“Our research shows that somewhere between $125 billion and $175 billion is spent every year on fraudulent health insurance claims in the U.S.,” said Mike Boswood, Truven Health Analytics president and CEO. “We have built an enormously successful practice helping healthcare payers identify and reclaim much of those funds through our statistical modeling capabilities, and the next frontier is preventing the problem altogether. By leveraging Fortel’s groundbreaking, predictive analytics technology, we are bringing more powerful, reliable pre-payment fraud solutions to the health care industry.”
Fortel’s healthcare predictive analytics are unique in their ability to quickly apply multi-dimensional scoring model to systematically review all pre-payment claims and immediately identify high-risk claims that should be denied for payment immediately or analyzed for further intervention and resolution.
Fortel’s analytical technology is based on an approach that was pioneered in the financial services industry and traces its roots to credit card fraud prevention technologies that have resulted in billions of dollars of savings to consumers and banks worldwide.
“Our exclusive relationship with Truven Health will create an unequaled pre-payment enterprise offering for program integrity across the healthcare marketplace,” said Allan Klindworth, Fortel Analytics CEO. “Truven Health has been on the forefront of using healthcare Big Data to stop fraud for many years and I am confident they will take our technology to new heights as they integrate it into their full suite of payment integrity solutions.”
Fortel’s healthcare fraud technologies will be integrated into Truven Health’s Payment Integrity Solutions offering, which serves a wide range of commercial and government healthcare payers, including large employers, health plans, the Centers for Medicare and Medicaid Services and state Medicaid agencies nationwide.
About Truven Health Analytics
At Truven Health Analytics we are dedicated to delivering the answers our clients need to improve healthcare quality and reduce costs. We are a healthcare analytics company with robust, widely-respected data assets and advanced analytic expertise that have served the global healthcare industry for more than 30 years. These combine with our unique perspective from across the entire healthcare industry to give hospitals, clinicians, employers, health plans, government agencies, life sciences researchers, and policymakers the confidence they need to make the right decisions, right now, every time. With our healthcare-specific expertise and tools for managing complex and disparate data, we understand how to implement and integrate tailored analytics that drive improvement.
Truven Health Analytics owns some of the most trusted brands in healthcare, such as Micromedex, ActionOI, 100 Top Hospitals, MarketScan, and Advantage Suite. Truven has its principal offices in Ann Arbor, Mich.; Chicago; and Denver. For more information, please visit www.truvenhealth.com.