ISO Extends Fraud Detection to Healthcare Market

Jersey City, N.J. — Extending its reach in healthcare market as a provider of data, analytics and decision-support solutions, ISO Properties Inc. confirmed the acquisition of Salt Lake City-based HealthCare Insight LLC (HCI), which provides solutions that enable healthcare claims payors to prevent fraud, abuse and overpayment. Terms of the deal were not disclosed.

HealthCare Insight combines automated modeling and profiling of claims with the enhanced accuracy available through clinical validation. Before reporting actionable results to clients, all suspect claims and billing patterns identified by HCI's software are reviewed by registered nurses, physicians, dentists, and other clinicians skilled in coding and reimbursement decisions. This combination of human and system review provides clients with claims payment accuracy.

"HCI provides payors with a suite of healthcare cost containment solutions that are both effective and accurate," says Frank J. Coyne, ISO's chairman, president, and chief executive officer. "These solutions, coupled with those offered by our Urix business unit, represent a powerful offering in the market." ISO's Urix business unit combines the Urix business intelligence platform with DxCG's predictive science.

Based in Jersey City, N.J., ISO provides products and services that help measure, manage and reduce risk, and is an established provider of fraud detection services in two other key markets—property/casualty insurance and mortgage lending.

HealthCare Insight will operate from its current Sandy, Utah, headquarters and will continue to be led by Barry Johnson. Johnson stressed that the transition to ISO ownership would be seamless to existing customers.

Source: ISO

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