NASHVILLE, Tenn., Nov. 17 Emdeon (NYSE: EM), a leading provider of healthcare revenue and payment cycle management solutions, today announced that its CEO, George Lazenby, recently authored a chapter in the new book "Stop Paying the Crooks: Solutions to End the Fraud That Threatens Your Healthcare." The book, published by the Center for Health Transformation, was edited by James R. Frogue with a foreword by Newt Gingrich.
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Lazenby authored Chapter 1, titled "Healthcare Fraud, Waste and Abuse: A Smarter Way to Deter and Prevent," which examines the prevalence of fraud, waste and abuse in the U.S. healthcare system and proposes a new approach to the detection, analysis, investigation and prevention of these issues. The chapter also explores healthcare fraud schemes and what they cost, outlines five core tenets to combat fraud and provides a road map to success.
"The healthcare industry is moving from a 'pay and chase' model of fraud, waste and abuse detection and recovery to a more sophisticated model that emphasizes prevention," Lazenby said. "The path from retrospective analysis to prospective and preventative analysis is clear. We believe that utilizing better, more robust data and technology at an earlier stage in the reimbursement process can provide the tipping point the U.S. healthcare industry needs to reduce fraud, waste and abuse."
Emdeon employs innovative fraud detection tactics through a holistic solution called payment integrity, which integrates emerging technology and data-driven analytics solutions to help prevent lost healthcare dollars. In his chapter, Lazenby also details the importance of a collaborative approach among all healthcare stakeholders, including the creation of a multi-payer data set and the need for combined efforts of payers and providers to revolutionize an ineffective system. Lazenby recognizes the difficulty of this task, but likens its necessity to the credit card industry, which spent many years and IT investment dollars developing the efficiencies it benefits from today.
Stop Paying the Crooks is available online at https://store.healthtransformation.net/ in both trade paper and downloadable PDF formats.
Separately, Emdeon will also issue a white paper titled, "Payment Integrity: New perspectives on, and approaches to, mastering the challenge of healthcare fraud, waste and abuse" at the National Healthcare Anti-Fraud Association conference in Orlando scheduled for November 17-19. The white paper explores the history, trends and challenges of preventing healthcare fraud, a problem that the Federal Bureau of Investigation estimates costs between three and ten percent of U.S. healthcare spending (between $75 billion and $250 billion in the 2009 fiscal year) on fraudulent billings to public and private healthcare programs.*
Emdeon Inc. (NYSE: EM) is a leading provider of revenue and payment cycle management solutions, connecting payers, providers and patients in the U.S. healthcare system. Emdeon's product and service offerings integrate and automate key business and administrative functions of its payer and provider customers throughout the patient encounter. Through the use of Emdeon's comprehensive suite of products and services, which are designed to easily integrate with existing technology infrastructures, its customers are able to improve efficiency, reduce costs, increase cash flow and more efficiently manage the complex revenue and payment cycle process. For more information, visit www.emdeon.com.
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* Source: Inside the FBI, Health Care Fraud Costs Billions, June 12, 2009