MediCall Announces "Clinical Investigative Unit" Service Line

Pleasanton, CA., May 8, 2010 – MediCall’s CEO John Chess announced today that the company has completed an agreement with one of the largest group health plans to provide a “Clinical Investigative Unit” or “CIU’” team comprised of highly trained licensed nurse teams conducting reviews on suspect claims for Fraud & Abuse and overpayment recovery. “With our extensive background supporting medical record review and clinical validation in such areas as Utilization Management and Auto Accident Claims, MediCall has the proven experience and is well positioned to deliver a highly scalable and cost effective solution to this growing issue” according to Chess.

 

Fraud and Abuse along with overpayment recovery of medical claims is a growing issue facing the industry today. The Insurance Research Council estimates that fraud and abuse losses in healthcare waste an estimated $70 to $255 billion annually and contributes substantially to the rising expenditures in healthcare. “Because reducing fraud and abuse in the health care system is a major focus for the administration’s  healthcare reform initiatives, the need for these specialize clinical review teams will only continue to grow”, Chess went on to say that recent increases in MediCall’s sales volumes reflect this growing need to couple a robust clinical review capability with automated software review platforms to effectively screen out and reduce the instances of fraudulent claims making their way through the healthcare system.

About MediCall

Headquartered in Pleasanton, California, MediCall, Inc. is a specialized medical management services organization addressing both the Group Health and Workers' Comp markets. MediCall clients include some of the largest national and regional carriers and TPA's in the country. MediCall offers global capabilities with multiple clinical operational centers staffed with healthcare professionals, enabling MediCall clients to easily extend the reach and capabilities of their medical and disability management programs 24/7/365. MediCall's network of healthcare staff includes over 850 experienced nurses, physicians, and pharmacists. With its breadth and depth of in-house healthcare expertise and URAC accredited, HIPAA compliant, secure healthcare IT infrastructure, MediCall is uniquely positioned to offer quality, cost-efficient healthcare focused services. The industry's staffing challenge due to the U.S. nursing shortage, combined with cost containment pressures being faced by today's insurance market, make MediCall's services an attractive option for any healthcare related company looking to achieve significant and measurable benefits.

For More Information, contact:

Michael Donlon

EVP, Business Development

MediCall
(925) 469-1290
mdonlon@medicall.us

 

 

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