BALTIMORE, June 7 /PRNewswire/ -- ViPS, Inc., a major provider of business intelligence solutions for healthcare and life science companies, today announced a multi-year licensing agreement with Medical Mutual, the oldest and largest health insurance company based in Ohio, for the ViPS’ anti-fraud software, STARSentinel(TM).
STARSentinel is an early-warning detection system that surveys health plan data and evaluates claims in the light of provider claims’ histories, specialty profiles and the most common, documented fraud schemes. By calling questionable patterns to management’s attention, STARSentinel helps prioritize cases and helps the plan’s Financial Investigations department use its resources with maximum productivity.
Medical Mutual serves more than 1.5 million people. Since 1983, the company has saved policyholders approximately $44 million through its aggressive pursuit of fraudulent claims. Medical Mutual investigates about 150 cases of possible fraud each year and often recovers $1 million or more per year in improper payments as a result of its vigilance. Brien Shanahan, Medical Mutual’s director of Financial Investigations, said emphasis on anti- fraud activities is critically important since healthcare fraud is estimated to cost American consumers more than $100 billion annually.
“Targeting suspicious claims, and identifying possibly fraudulent billing patterns, are a key part of our effort to control costs and deliver high- quality care, affordable health insurance products,” added Shanahan. “What is particularly valuable about STARSentinel is the way it also supports provider education and helps identify improper billings that may be the result of simple errors and misunderstandings.”
“In the long run, controlling improper payments will improve both business results and the quality of care that is delivered,” stated Jenny Morgan, president and chief executive officer at ViPS. “With a product like STARSentinel, Medical Mutual can continue its long track record of containing loss and improving performance.”
About Medical Mutual of Ohio
Founded in 1934, Medical Mutual is the oldest and largest health insurance company based in Ohio. The company serves its customers through high-quality, affordable group and personal health insurance plans, and third-party administrative services to self-insured group customers. Medical Mutual’s annual premium and service-generated revenue in 2003 was $1.9 billion. Based in Cleveland, Medical Mutual also has offices in Columbus, Cincinnati, Toledo, Akron, Dayton and Youngstown. For more information, visit the company’s award-winning web site at http://www.medmutual.com/.
About ViPS, Inc.
ViPS delivers innovative business intelligence that simplifies the business of health - providing advanced care, claims, risk and performance management solutions as well as fraud prevention and clinical trial solutions. A privately held firm headquartered in the Baltimore-Washington, DC metro area, the company operates three business units under the names ViPS Government Solutions, ViPS HealthPayer Solutions and ViPS BioMedical Services and serves commercial and government clients, from large health plans, major managed care organizations and global pharmaceutical organizations to leading federal agencies and contractors. For more information, visit http://www.vips.com/, email webinfo@vips.com or call 888-289-8477.
ViPS expressly reserves the right to make changes to these materials, or to the software products described herein, at any time without notice.
ViPS, Inc.
CONTACT: Jana Von Bramer, ViPS, Inc., +1-410-832-8300
Web site: http://www.medmutual.com/
Web site: http://www.vips.com/
