SOURCE: HealthCare Insight

October 05, 2009 10:28 ET

HealthCare Insight Announces Launch of New Cancer Management Service, OncologyClaim Insight™

HCI Adds New Oncology Service to Suite of Products

SALT LAKE CITY, UT--(Marketwire - October 5, 2009) - HealthCare Insight (HCI), a division of Verisk Health, Inc., and a provider of clinically validated fraud, abuse, and overpayment prevention solutions for private and public-sector payors, announced today the release of a new care management program for oncology claims.

OncologyClaim Insight™, powered by Biologics, Inc.'s best-in-class cancer management strategy for payors, is a prepayment service designed to elevate patient care, enhance provider satisfaction, and manage oncology costs. This new clinically based service has been implemented to help HCI clients reduce the costs of cancer care while realizing an ROI of more than 8:1. Service features include 100 percent oncology case eligibility review, patient management, and education performed by an individually assigned Oncology Certified Nurse (OCN); detailed claim audits; validation and documentation of complex care plans that meet evidence-based national guidelines; access to an expert oncologist advisory panel; and detailed program performance reports.

A key component of the service is to support patients as they navigate the maze of providers and help to avoid potentially dangerous duplicate tests, procedures, or unnecessary and/or inappropriate treatment plans. HCI formed a strategic alliance with Biologics to implement a solution that results in appropriate reimbursement for payors and providers while ensuring that patients receive additional clinical support throughout their treatment.

"OncologyClaim Insight assures the employer, payor, and patient that the most appropriate plan of treatment is delivered and that patients receive a high level of clinical support to give them the best opportunity for a positive outcome," said Brian Smith, executive vice president of sales for HealthCare Insight.

"We are honored to provide the clinical oncology expertise for OncologyClaim Insight," said Robin U. Smith, chairman and chief executive officer of Biologics, Inc. "HCI is progressively addressing the complexities of cancer care to serve its payors, providers, and, most important, the patients."

About HealthCare Insight (HCI)

HCI, a division of Verisk Health, Inc., provides private and public-sector health care claims payors (including health plans, managed care organizations, insurance carriers, third-party administrators, Medicaid, and Medicare) with a comprehensive suite of clinically validated fraud and abuse surveillance services designed to maximize claims administration accuracy and minimize payment waste. Each of HCI's customizable software-as-a-service (SaaS) solutions relies on a unique prepayment process that combines proprietary software systems with detailed review by experienced clinicians (doctors, nurses, and dentists) and investigators on all suspect claims and billing patterns. HCI's differentiated process enables payors to target fraud with greater efficiency by significantly increasing the quality of results returned. For more information and to learn about HCI's no-cost Cost Reduction Analysis, please visit or call 1-877-619-5557.

About Biologics, Inc.

Biologics, Inc. is a cancer management company with an innovative business model that brings together the many complex components of cancer care to provide a patient-focused platform for managing the financial, emotional, and physical burdens of cancer treatment. Biologics is at the center of the rapidly changing oncology environment, managing multiple treatment modalities, clinical outcomes, and informatics and leveraging established relationships with oncology clinicians, patients, payors, researchers, and manufacturers. The company operates four divisions: Oncology Pharmacy, Oncology Clinical Trial Services, Oncology Management Services for Payors, and Oncology Biopharmaceutical Solutions. Since it was founded in 1994, Biologics has been dedicated to improving the lives of those fighting cancer. Biologics, Inc. is a privately held company with headquarters and operations in Cary, N.C. Visit for more information.

Contact Information

  • Press Contact:
    Ronnie Welch
    CWR & Partners, LLP
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