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TriZetto Buys Gateway EDI Medical Claim and Payment Company-More Medical Financial Algorithms Adding Power to the Payers

I have covered TriZetto, which is somewhat of a competitor of Ingenix when it comes to analytics and providing the least cost routing in healthcare. We all still question and should whether or not this represents the best care. I have included...

Published Tue, Feb 02 2011 1:34 PM by The Medical Quack

Filed under: Medically Related, Technology, My Commentaries, healthcare, Claims, Business Intelligence, India, payers, Records, Ingenix, healthcare cost, EOB, Trizetto, reimburements, Tela Sourcing, Gateway EDI

New FAIR Data Base Slated to Be Available Later this Year To Replace the Corrupted Data Base Used by Ingenix to Calculate Out of Network Insurance Charges

A while back, Andrew Cuomo investigated and found the data base to be low balling the rates and thus many doctors and patients were under paid on claims, some for about 15 years. One by one carriers agreed to stop using the data base, In addition...

Published Wed, Jan 01 2011 3:32 AM by The Medical Quack

Filed under: Medically Related, Technology, Insurance, health insurance, Claims, Ingenix, consumers, out of network, Fair data base, normal and customary charges

Ingenix (Subsidiary of United Health Group) Sells i3 Clinical Trials And Creates Life Sciences Group-Subsidiary Watch

In case you missed the news, record profits again were maintained by United for the year and the 4th quarter. The Ingenix division is the group that runs all the business intelligence analysis programs and creates software, in other words they write ...

Published Fri, Jan 01 2011 4:15 PM by The Medical Quack

Filed under: Medically Related, Insurance, health insurance, Health IT, clinical trials, Life Sciences, Algorithms, Mergers and Acquisitions, Ingenix, inVentiv Health, consulting, Innovus

UnitedHealth Group Reports Record Profits for 2010 of $1.80 Billion-Algorithm Revenues Up with Subsidiary Groups Too

Below are some of the highlights from the press release you can read in it’s entirety at the link at the bottom of the post. Profits were up from last year which came in at $1.58 Billion and basically people were not going to the doctor was one...

Published Thu, Jan 01 2011 2:59 PM by The Medical Quack

Filed under: Medically Related, Insurance, My Commentaries, drugs, Medical Devices, FDA, Heatlhcare, China, Profits, Mergers and Acquisitions, Ingenix, i3, revenue, ChinaGate, itedHealthcare

Insurers Setting Up to Bid on State Medicaid Plans-Bring in IT Infrastructure and Data Systems to Run It on Outsourced Basis

Today we had the announcement of CMS to begin their IT Infrastructure upgrade and again this is after 8 years of asleep at the wheel by a prior administration and it’s catch up time and it’s not pretty. Now the insurers are feeding on states wanting...

Published Tue, Dec 12 2010 10:07 PM by The Medical Quack

Filed under: Medically Related, Technology, Insurance, EMR, medicare, EHR, Claims, Medicaid, Non Profit, Algorithms, incentives, Wellpoint, Contracts, Ingenix, healthcare reform, shareholders, United Heatlhcare

Bethesda Healthcare Selects Ingenix, A Wholly Owned Subsidiary of United HealthCare To Manage Revenue Cycles-Subsidiary Watch

There’s a lot of money in writing these financial algorithms and here’s one more case with profits going to the bottom line of the parent company. In reading this press release though it seems that the cost to the healthcare system will be minimal...

Published Tue, Dec 12 2010 2:28 PM by The Medical Quack

Filed under: Medically Related, Insurance, My Commentaries, health insurance, Doctors, Algorithms, United HealthCare, Profits, Ingenix, scoring health claims, Medical Society, subsidiary watch, Bethesda Medical

Medicare Federal Investigators Getting Algorithms to Analyze And Find Fraud-Good Move as Contractors Efforts Are Weak With Risking Loss Of Transaction Revenue

This is a good deal if in fact it is available for use for the government and not outsourced to contractors as when you read the news , they are not making any waves when handling claims for Medicare in finding fraud as fraudulent claims as well as legitimate...

Published Thu, Dec 12 2010 4:42 PM by The Medical Quack

Filed under: Medically Related, Technology, Insurance, My Commentaries, EMR, healthcare, medicare, EHR, Claims, Fraud, Non Profit, Algorithms, incentives, Contracts, Ingenix, healthcare reform, shareholders, United Heatlhcare

Transaction Fees and Services Account for Large Expenditures in Health IT -Those Algorithmic Processes Creating Profits-Subsidiary Watch

The average layman is normally not aware of all the processes and transaction charges that are coupled with processing a medical claim. This is a huge profit area with algorithmic formulas that are sold to companies in the business of processing...

Published Wed, Dec 12 2010 12:56 PM by The Medical Quack

Filed under: Medically Related, Technology, Insurance, My Commentaries, healthcare, health insurance, EHR, HHS, Algorithms, Mergers and Acquisitions, Ingenix, transactions, UnitedHealthGroup, Executive Heatlh Resources

UnitedHealthcare Disrupts Insulin Users So Either Change or Pay More–No Generics Here, Just a Bidding War For A Contract

NovoLog users can avoid a price spike by switching to another insulin, Humalog per United Healthcare and this is all a shake up of a bidding/contract situation, so who ever comes in at the lower bid moves to the cheap spot at tier 1 and the other ends...

Published Mon, Dec 12 2010 8:16 PM by The Medical Quack

Filed under: Medically Related, Pharma/FDA News, drugs, Medical Devices, FDA, Diabetes, insulin, Heatlhcare, China, UnitedHealthcare, Mergers and Acquisitions, Ingenix, Formularies, tiers, i3, ChinaGate

VA Awards Contract to Picis, Subsidiary of Ingenix for Anesthesia Record Keeping Software

Picis before the acquisition by Ingenix already had many hospital installations so it appears this is to be one more area of revenue generation for Ingenix, a wholly owned subsidiary of United Healthcare. During the last year Ingenix purchases several...

Published Fri, Dec 12 2010 2:40 AM by The Medical Quack

Filed under: Medically Related, Technology, Insurance, Medical Records, VA, Hospitals, software, Government, Algorithms, Contracts, Ingenix, ICU, monitoring, anthesia

Veterans Health And Allen Memorial Hospital in Utah Connecting- Pilot Program With UHIN Via Axolotl, an Ingenix Subsidiary

This will allow records from the VA and rural healthcare providers to share and coordinate medical records. This scores some additional revenue for United Healthcare as the company is owned by Ingenix, which is a subsidiary of United. Axolotl...

Published Fri, Dec 12 2010 12:33 AM by The Medical Quack

Filed under: Medically Related, Technology, Health IT, VA, HIE, Ingenix, ARRA, aggregation, algoirthms, United Health Group, Axolotl, health inforamtion exchange

UnitedHealthcare Begins Pharmacy Saver for Medicare Plan Members January 1st-Better Record Tracking for Compliance at $2.00 For Generic Drugs or Existing Co-Pay

Here we go again, half off of the $4.00 prescriptions already offered by Kroger, Walmart and others. This may not sound like a big deal if you are already paying $4.00 but your data and prescription refill information is like gold and part of the...

Published Mon, Nov 11 2010 5:25 PM by The Medical Quack

Filed under: Medically Related, Pharma/FDA News, My Commentaries, Pay for Performance, Safeway, doctor, Primary Care, Layoffs, Outsourcing, Algorithms, Express Scripts, Ingenix, pharmacists, Kroger, wellness, transactions, analysis, UnitedHealthare, P4P

HealthNet in Connecticut to Lay Off 750 Employees as United Healthcare Takes Over Membership In the Northeast

This all happened back in September of 2009 and now as contracts expire and are not renewed with members moving over to United Healthcare, the jobs are going. United HealthCare Purchase of HealthNet in the Northeast Did Not Include Transfer of Employees...

Published Fri, Nov 11 2010 6:25 PM by The Medical Quack

Filed under: Medically Related, Insurance, health insurance, Hospitals, Government, Data, Algorithms, United HealthCare, Ingenix, healthcare reform, HealthNet, Patients Not Profit, state laws

China May Surpass the U.S. As the World’s Strongest Economy within Two Years While We Still Focus On Entertaining Ourselves

This is a pretty scary statement to all of us living in the US, although this has been in the news for years and this is especially crucial in healthcare, where we can’t seem to get our act together here in the US. While there are almost more speaking...

Published Thu, Nov 11 2010 1:03 PM by The Medical Quack

Filed under: Medically Related, Other Items of Interest, drugs, Medical Devices, FDA, Heatlhcare, China, UnitedHealthcare, Mergers and Acquisitions, Ingenix, i3, ChinaGate

Grassley Investigating Medicare Contractor Conflicts of Interest–Some Are Owned by Subsidiaries of Health Insurance Companies- Will That Do It? Get An “Algo Man” For Help

Here’s a screenshot below from a prior post that gives one a Wellpoint email address if your have “Congressional concerns” and I don’t know about you, but if I had issues I think I would send my issues direct to Congress as a citizen, right? Again...

Published Fri, Oct 10 2010 6:08 PM by The Medical Quack

Filed under: Medically Related, Technology, Insurance, EMR, healthcare, medicare, EHR, Claims, Fraud, Non Profit, Algorithms, incentives, Wellpoint, Contracts, Ingenix, healthcare reform, Grassley, shareholders, United Heatlhcare

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