Lovelace Integrates First Insight | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Lovelace Integrates First Insight

May 23, 2007
by root
| Reprints

Lovelace Health Plan (Albuquerque, N.Mex.) is integrating HealthCare Insight's (HCI) e code editing and clinical review service into its claims review processes.

The service, called First Insight, will ensure accurate claims reimbursement, provide support in instances of appeals, and identify aberrant provider activity that may indicate fraud, says HCI.

According to HCI, the service combines its proprietary Code Corrector (rules-based) and Fraud Finder Pro (profiling) software systems with claims review by RN Coding Specialists and suspect provider validation by a Clinical Investigative Unit (CIU). Payers that integrate First Insight e into claims adjudication operations realize savings from $1 to $5 per member per month (PMPM) over and above existing claims payment processes, contends the Sandy, Utah-based company.



Former Health IT Head in San Diego County Charged with Defrauding Provider out of $800K

The ex-health IT director at North County Health Services, a San Diego County-based healthcare service provider, has been charged with spearheading fraudulent operations that cost the organization $800,000.

Allscripts Touts 1 Billion API Shares in 2017

Officials from Chicago-based health IT vendor Allscripts have attested that the company has reached a new milestone— one billion application programming interface (API) data exchange transactions in 2017.

Dignity Health, CHI Merging to Form New Catholic Health System

Catholic Health Initiatives (CHI), based in Englewood, Colorado, and San Francisco-based Dignity Health officially announced they are merging and have signed a definitive agreement to combine ministries and create a new, nonprofit Catholic health system.

HHS Announces Winning Solutions in Opioid Code-a-Thon

The U.S. Department of Health and Human Services (HHS) hosted this week a first-of-its-kind two-day Code-a-Thon to use data and technology to develop new solutions to address the opioid epidemic.

In GAO Report, More Concern over VA VistA Modernization Project

A recent Government Accountability Office (GAO) report is calling into question the more than $1 billion that has been spent to modernize the Department of Veterans Affairs' (VA) health IT system.

Lawmakers Introduce Legislation Aimed at Improving Medicare ACO Program

U.S. Representatives Peter Welch (D-VT) and Rep. Diane Black (R-TN) have introduced H.R. 4580, the ACO Improvement Act of 2017 that makes changes to the Medicare accountable care organization (ACO) program.