Fraud, Waste &amp; Abuse Companies

Product Info

Min. Group Size

-

Lives Serviced

-

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

Personify Health has developed a robust and sophisticated fraud prevention and recovery program. This program is built upon a combination of cutting-edge technology, extensive expertise, and strong partnerships. Continuous updates to our library... Show More

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Case IQ

Reviews pending

Product Info

Min. Group Size

100 eligible

Lives Serviced

-

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

Uncover, Investigate and Prevent Incidents and Misconduct

Case IQ is a powerful employee hotline and case management platform that streamlines your investigative process. Case IQ provides the data you need... Show More

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6 Degrees Health

Reviews pending

Product Info

Company Overview

Founded

2012

Employees

141

Funding Summary

Not Provided

Clients Your Size

About 6 Degrees Health

6 Degrees Health is a service-first cost containment company. For many, we set care free from the constraints of traditional networks. For others, we bring integrity to historically opaque billing practices. For all, we leverage unparalleled clinical expertise and innovative data technology to empower employers and their covered employees in realizing the true benefit of healthcare.

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Cotiviti

Reviews pending

Product Info

Company Overview

Founded

2004

Employees

8,573

Funding Summary

Not Provided

Clients Your Size

About Cotiviti

Cotiviti is a leading solutions and analytics company that is reshaping the economics of healthcare, helping its clients uncover new opportunities to unlock value. Cotiviti’s solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, and network performance management programs. The company also supports the retail industry with data management and audit services that improve business outcomes. Show More

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Milu Health

Reviews pending

Product Info

Min. Group Size

-

Lives Serviced

-

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

Milu's BillFighter tool flags medical bills with potential mistakes, notifies employees of these potential mistakes, and offers to dispute the bill on their behalf. Bills with mistakes are flagged from claims or EHR... Show More

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Willrithms

Reviews pending

Product Info

Company Overview

Founded

Employees

Funding Summary

Not Provided

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Prime Therapeutics

Reviews pending

Product Info

Company Overview

Founded

1987

Employees

Funding Summary

None

Clients Your Size

About Prime Therapeutics

Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 20 years.

In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 27+ million members throughout the US.

In addition to core PBM services, we... Show More

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BMI Audit Services

Reviews pending

Product Info

Min. Group Size

100 eligible

Lives Serviced

1,000,000,000

Average Cost

0 RFI Questions

0 Specific Questions

Product Features

Not Provided.

Product Description

See the description for Healthcare Claims Data Analytics Show More

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Innovu

Reviews pending

Product Info

Company Overview

Founded

2014

Employees

85

Funding Summary

Not Provided

Clients Your Size

About Innovu

Innovu is dedicated to helping advisors and their clients stay ahead of the curve regarding benefits strategy. Our SAAS platform and comprehensive menu of targeted solutions have been thoughtfully designed to help you optimize human capital risk management, health benefit design, and procurement through fully integrated claims data, predictive analytics, and health information insights. With Innovu, you'll not only be able to drive savings opportunities for your clients, but you'll also be able to provide financial reporting and tools for plan sponsors to adhere to the Consolidated Appropriations Act. Additionally, you can dive deep into the available data through the... Show More

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Alliant Health Solutions

Reviews pending

Product Info

Company Overview

Founded

1970

Employees

Funding Summary

Not Provided

Clients Your Size

About Alliant Health Solutions

Alliant Health Solutions is a nonprofit organization driven to make health care better in the United States by improving quality of care, increasing the value of health care, and promoting prevention and treatment for chronic illnesses. Our family of companies provide professional services to state, federal and private partners, supporting the effective administration of health care programs and improvement initiatives. Alliant has three primary lines of service offerings that leverage evidenced-based methods, data and technology, and clinical expertise
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First Healthcare Compliance

Reviews pending

Product Info

Company Overview

Founded

2012

Employees

Funding Summary

Not Provided

Clients Your Size

About First Healthcare Compliance

We help create confidence among compliance professionals through education, resources, and support in the areas of HIPAA, OSHA, human resources compliance, and fraud waste and abuse laws. Our flexible, scalable, secure, cloud-based software allow organizations to: Share, track, and manage their compliance processes with ease; View compliance status in real time, across all locations; Have peace of mind that they are current in all federal healthcare regulatory areas.
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Integrity Advantage

Reviews pending

Product Info

Company Overview

Founded

2017

Employees

Funding Summary

Not Provided

Clients Your Size

About Integrity Advantage

Integrity Advantage is the way healthcare payers reimagine the value of their fraud, waste and abuse program. We’ve built our diverse knowledge base through decades of doing. Our experience providing support to dozens of plans across all lines of business, geographical regions, and varying enterprise priorities give our clients a tremendous advantage. We are a vendor neutral trusted advisor, providing objective perspectives and offering solutions for real challenges faced by the payment integrity industry. We offer advisory consulting, strategic planning, detection, investigation, medical review and training services to support program integrity initiatives in the identification and prevention of healthcare fraud,... Show More

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Qlarant

Reviews pending

Product Info

Company Overview

Founded

1973

Employees

Funding Summary

Not Provided

Clients Your Size

About Qlarant

For 48 years, our history has been rooted in commitment to quality improvement for organizations — and quality of life for the people they serve. We began as Delmarva Foundation for Medical Care in 1973 on Maryland’s Eastern Shore as one of the country’s first quality review organizations for the Centers for Medicare and Medicaid. Through the decades, we created entities that became nationally known, including Delmarva Foundation, Health Integrity, and Quality Health Strategies. Today, we’ve brought together these extensive resources and the expertise of more than 500 professionals under one name — Qlarant — serving some of our nation’s... Show More

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Zigron Inc.

Reviews pending

Product Info

Company Overview

Founded

2006

Employees

Funding Summary

Not Provided

Clients Your Size

About Zigron Inc.

Zigron was founded in 2006 by enthusiastic and dynamic gurus. Zigron specializes in Cloud and SaaS based solutions, Big Data Analytics, New Platform/Product Development, Rich User Experience, User Experience Modernization/Unification and Advanced Data Visualization in Telecom, Wireless, Broadcast, Satellite, M2M and Networks, SDN/NFV, Open stack, Cloud engineering, Cloud infrastructure management, DevOps, Data sciences and Automation testing .Over the last 10 years, Zigron has worked with more than 70 plus companies.
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360 Health Systems, Inc.

Reviews pending

Product Info

Company Overview

Founded

2014

Employees

Funding Summary

Not Provided

Clients Your Size

About 360 Health Systems, Inc.

We aim to empower Health Plans and Payor Healthcare Organizations with a unique, easy-to-use and unparalleled technology of tomorrow to catch improper claims payments. 360 Health System's digital and non-traditional approach enables you to take full control over your Payment Integrity Operations to meet and exceed your financial recovery objectives.
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ACS - Training & Technologies

Reviews pending

Product Info

Company Overview

Founded

1970

Employees

Funding Summary

Not Provided

Clients Your Size

About ACS - Training & Technologies

Established in 1970, ACS is well established and reputed privately owned technology-enabled services and solutions company with advanced capabilities in training & consultancies, medical billing, medical transcription, and web and software services. We design and deliver quality training courses beyond what is expected by the customer at a competitive price.
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Alaffia Health

Reviews pending

Product Info

Company Overview

Founded

2020

Employees

Funding Summary

Not Provided

Clients Your Size

About Alaffia Health

Alaffia Health is a healthtech company that uses machine learning and AI to identify and eliminate provider fraud, waste, and abuse in healthcare claims. We work with health plans, TPAs, self-funded employers, reinsurers, and government agencies to lower healthcare costs by eliminating overpayments.
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Barrow Wise Consulting, LLC

Reviews pending

Product Info

Company Overview

Founded

2012

Employees

Funding Summary

Not Provided

Clients Your Size

About Barrow Wise Consulting, LLC

After gaining more than 20 years of expertise in IT consulting and building strong customer relationships across the private and government sectors, our Founder created Barrow Wise Consulting, LLC in 2012, with a commitment to learning from clients and delivering solutions that reduce costs, improve operational efficiencies, solve business challenges, and increase the value of IT investments. With transformative consulting and engineering solutions, Barrow Wise has helped secure the largest global cyber security program, transform the largest network, and strengthen the government’s most extensive payment system.
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Brighterion

Reviews pending

Product Info

Company Overview

Founded

2000

Employees

Funding Summary

Not Provided

Clients Your Size

About Brighterion

Brighterion, a Mastercard company, was founded in 2000 and acquired by Mastercard in 2017. Building on our experience in preventing financial crime, Brighterion was engaged by Mastercard in 2006 to deploy our AI-based fraud solution for payments amongst its issuing banks. Mastercard integrated that technology across its Decision Intelligence platform in 2016.
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ClaimInformatics

Reviews pending