Eliminating Healthcare Fraud Through Technology HCT Project Volume 4, January 30, 2007
There are many types of healthcare fraud. It can be driven by healthcare and insurance providers, patients, employers or any combination of the above. Healthcare providers might make claims for services not provided, or overcharge for services they did provide.
James Taylor, Fair Isaac Corporation

 Enterprise-Class 360° Revenue Cycle Management Solutions for the Patient-Centric Provider HCT Project Volume 4, January 30, 2007
GHN is an enterprise-class revenue cycle management company providing complete and accurate electronic claims transaction solutions to healthcare payers and providers in real time via the Internet.

 Claims Management and Legacy Integration HCT Project Volume 3, November 14, 2005
To strengthen the connections between patient systems and payer claim systems, healthcare organizations need to integrate their technologies by modernizing their legacy systems.
Rick McNabb, Accenture

 Care Management HCT Project Volume 2, July 17, 2004
Care management broadly addresses the health services provided, helping to assure appropriate outcomes. It encompasses a wide range of functions undertaken by payers and providers. By working together, they can enhance the quality that plan members and patients receive.
Kimberley O''Keefe, Accenture, Noreen Fleming, Capgemini, Marj Bogaert, R.N., M.S.N, Capgemini

 CDHP: Getting the Customer Involved In Managing Health Care Costs HCT Project Volume 2, July 17, 2004
Employers, payers, and providers know that the health care system is moving toward greater consumer involvement and that this evolution will radically change how they manage information and communication.
Laurie Knutson, Capgemini, Kimberley O'Keefe, Accenture

 Health Plan Operations in the New World Of Health Care Financing HCT Project Volume 2, July 17, 2004
If new consumer-directed health plan products and systems can continue to be effectively implemented and supported by payer organizations, they could prove to be the sought-after solution to the health care cost dilemma.
Kevin R. Brown, Amisys Synertech Inc.

 NEHEN: An Electronic Transaction Exchange for Massachusetts' Health Care System HCT Project Volume 2, July 17, 2004
Fundamentally different from the typical health care electronic translation model needed in the marketplace, the NEHEN is a standards-based approach for exchanging HIPAA-compliant eligibility transactions with minimum administrative costs to the members.
John D. Halamka, M.D., M.S., NEHEN

 Payer-Provider Collaboration Increased EDI HCT Project Volume 2, July 17, 2004
Capgemini assisted BCBSM to accomplish a major push to become compliant in terms of meeting the HIPAA mandates. That’s only the first stage. After migration is complete, this will begin a maturity lifecycle in the industry where transactions will become more content rich, utilized, and integrated over time.
Deborah Fritz-Elliott, Blue Cross Blue Shield of Michigan, Don Hodgson, Capgemini

 Pharmacy Automation: Bothwell Regional Health Center Improves Patient Safety, Efficiency and Inventory Control HCT Project Volume 2, July 17, 2004
Amerinet – the most innovative and effective health care group purchasing organization in the country – leads the industry in flexibility and choice.

 Smart Cards HCT Project Volume 2, July 17, 2004
CDHP, facilitated by smart cards, will give customers better choices and a sense of ownership toward their decisions. A smart card in a patient’s pocket empowers a new perspective on health services.
Laurie Knutson, Capgemini