AMPS and TC3 Health Announce Affiliate Partnership - Insurance News | InsuranceNewsNet

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July 14, 2010 Newswires
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AMPS and TC3 Health Announce Affiliate Partnership

Advanced Medical Pricing Solutions (AMPS) and TC3 Health, Inc. (TC3) recently announced an affiliate partnership to expand the healthcare cost containment offerings of both companies. TC3 is the premier provider of fraud, waste and abuse detection services for healthcare payers throughout the United States. Since 2000, TC3 has provided integrated loss control solutions to health care payers on a pre-payment and post-payment basis through its TruClaim(SM) Payment Integrity Platform. TC3's TruClaim(SM) platform includes: proprietary rules-based fraud diagnostics; clinical code edit compliance and sophisticated duplicate detection technology; a robust suspect provider watch list; web-defense portal; CaseTracker software to automate and manage investigations and other fraud management functions, and a fully staffed investigative unit to conduct rational and defensible fraud, waste and abuse investigations. Combined, these services yield 1%-3% paid medical reduction. "TC3 is obviously the preeminent player in the pre-payment Fraud and Abuse space and they have clearly separated themselves from their competitors both in terms of technology, the breadth of their offering and savings outcomes. We see our affiliation with TC3 as a perfect complement to our cost containment offerings," said Mike Dendy, President and CEO of AMPS (see also Medicare and Medicaid).

AMPS, a privately held company, represents payers across the U.S. to confirm accurate billing by hospitals for healthcare services provided. Founded in 1995, AMPS has offices in Atlanta, GA and Phoenix, AZ. AMPS' reviews of hospital claims have yielded an average cost savings of 19.75% (over and above PPO discounts). With an average size of claim reviewed of $65,500, this has yielded an average additional dollar reduction of $11,707 per claim.

"AMPS has an outstanding record of success in reviewing hospital claims accurately and fairly. The detail and consistency of their reviews, the utilization of licensed physicians to perform their audits, and the integration of legal services and an insurance policy to defend and indemnify their recommendations are the reasons why we feel AMPS will be of great value to our clients. TC3's affiliation with AMPS expands our integrated cost containment portfolio immensely," said Tim Huke, Vice President of Sales & Marketing for TC3.

Additionally, AMPS recently announced the completion and deployment of its proprietary hospital pricing transparency and analysis model (TAM). AMPS' TAM system evaluates claims by comparing its clients' hospital billings against reasonable and customary fees for like services from similar facilities and by juxtaposing cost to charge data on services provided. AMPS generates the data base for the TAM system through both public and private sources including Medicare claims data (MedPAR and OPPS), hospital cost reports, and other files obtained from the federal Centers for Medicare and Medicaid Services (CMS).

For additional information on AMPS, please visit www.advancedpricing.com or call Jim Delaney, COO, in Atlanta, GA at 678-528-3041.

For additional information on TC3, please visit www.tc3health.com or call Tim Huke, Vice President of Sales, in Irvine, CA at 949-943-8707.

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