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LexisNexis Risk Solutions Enhances Data Analytics and Identity Management to Health Care Industry to Fight Fraud
Published on Nov 16, 2010

LexisNexis® Risk Solutions announced its entrance into the health care market with identity management and data analytics solutions to help health care payors (such as commercial health plan providers and government agencies) ensure appropriate access to personal health information and eliminate fraud. The solutions provide identity verification and authentication, and on-going monitoring of a patient’s and provider’s identity via a knowledge-based authentication system. This will help health care providers, patients and payors to prevent fraud at the beginning of the health care cycle, before care is given.

“LexisNexis Risk Solutions is working with all parts of the health care ecosystem, including payors and providers, to deliver actionable insight and analytics that enhances their ability to meet the challenges of health care reform,” said Harry Jordan, vice president of health care for LexisNexis Risk Solutions. “This represents a transformational shift in the way the health care industry can leverage data to improve patient outcomes, combat fraud and enhance operational profitability.”

To support identity management, LexisNexis Risk Solutions is applying its verification and authentication solutions and advanced identity analytics to help public sector health organisations, commercial payors, state HIEs, EMR vendors, and others ensure secure access to health programs and networks. By improving access to information via identity verification and authentication, LexisNexis Risk Solutions is able to ensure secure and appropriate access to EMRs, provide timely intelligence to provider and beneficiary enrollment programs, ensure appropriate access to electronic records, and successfully comply with data access regulations.

LexisNexis Risk Solutions is also helping commercial payors, public sector agencies, claims processing vendors and investigative agencies enhance their ability to combat health care fraud, waste and abuse, by leveraging predictive modeling and pre- and post-claim analytics capabilities, as well as other investigative tools. As a result, health care organisations can implement an appropriate fraud risk control environment across the payment workflow utilising a multi-layered approach to proactively identify and prevent fraud, leading to cost savings and enhanced operational efficiency.

Finally, LexisNexis Risk Solutions is enhancing the ability of disease management organisations, payors and public health care agencies to manage health and disease outreach and increase participation rates in wellness programs by leveraging public data and analytics to identify and target receptive individuals. By providing enhanced population intelligence for health care programs, LexisNexis is reducing the costs of recruiting patients and ensuring the accuracy of data used to develop tailored prevention and wellness programs.**

Source: Business Wire

Vendor name: LexisNexis® Risk Solutions
Product type: Business Intelligence | Data | Fraud Detection / KYC | Healthcare | Risk Management

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