Credit reporting and marketing services firm Experian Information Solutions Inc. will significantly increase its footprint in the health care industry with a $185 million definitive agreement to acquire Medical Present Value, which sells software enabling providers to monitor the performance of health insurers' compliance with their own contracts.
Costa Mesa, Calif.-based Experian's first big move in health care came in 2008 when it bought data validation software vendor SearchAmerica. Its offerings include applications to verify patient demographic information, predict the likelihood of payment, screen patients for eligibility for insurance coverage or charity care, and direct patients to financial counseling prior to completing registration. Search America also offers prospective data breach response service that includes plan development, call center and consumer notification services, and preferred pricing for credit/identity protection services from Experian.
Now, Austin, Texas-based MPV, with 75,000 provider clients in 310 organizations that primarily are large group practices, brings new provider revenue cycle management tools, as well as the ambulatory market, to Experian.
The software, loaded with terms of a practice's contracts, enables analysis of expected reimbursement and actual payment to flag underpayments or overpayments. The software also enables evaluation of payer compliance that can be used when renegotiating contracts. Users can analyze the financial effect of proposed terms. Another module calculates expected patient responsibility at or before the time of service.
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