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McKesson Releases Newest Component of Fraud, Waste and Abuse Management SuiteOctober 07, 2010 |
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Toolset Addresses Payment Leaks That Fall Outside Traditional Fraud to Enhance the McKesson Total Payment Suite McKesson announces the Waste and Abuse KnowledgePack as the latest component of its Total Payment™ Solution, the McKesson end-to-end payment management suite. A recent report from Thomson-Reuters concluded that nearly a third of healthcare spending may not contribute to better outcomes for patients. Going beyond traditional fraud and abuse, wasteful spend, or payment “leakage,” can include medical and administrative inefficiencies such as payment for incorrectly coded claims or for claims that do not comply with established payment, medical or contract policy. McKesson has introduced this KnowledgePack as a first line of defense in helping the industry control a portion of the roughly $700 billion in wasteful annual healthcare spend. The Waste and Abuse KnowledgePack specifically addresses incorrect or abusive claims coding issues with the use of clinical rules-based technology. It contains McKesson-supported content and logic that identifies wasteful payments, billing errors and abusive billing often missed by payors’ systems. By looking across claims, dates, and providers, it identifies additional patterns of over-utilization and inappropriate billing. “With the Waste and Abuse KnowledgePack, customers can automatically stop problem claims, thereby reducing the administrative cost,” said Jim Evans, vice president, Claims Performance, McKesson Health Solutions. “The module also manages medical costs by preventing abusive or wasteful claims payments. Another benefit is improved provider satisfaction as issues are addressed early through adjudication and education, rather than from punitive investigations and recoveries.” The KnowledgePack content helps automate the healthcare claims adjudication process for those claims most likely to be abusive or wasteful. Health plans will use it to help reduce administrative costs, while helping to manage medical spend and improve provider satisfaction. About McKesson Corporation McKesson Corporation, currently ranked 14th on the FORTUNE 500, is a healthcare services and information technology company dedicated to helping its customers deliver high-quality healthcare by reducing costs, streamlining processes, and improving the quality and safety of patient care. Over the course of its 177-year history, McKesson has grown by providing pharmaceutical and medical-surgical supply management across the spectrum of care; healthcare information technology for hospitals, physicians, homecare and payors; hospital and retail pharmacy automation; and services for manufacturers and payors designed to improve outcomes for patients. For more information, visit http://www.mckesson.com .
PR Contact
McKesson Health Solutions
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