ATLANTA – Cost-containment specialists Advanced Medical Pricing Solutions (AMPS) and TC3 Health Inc., of Irvine, Calif., have joined forces to broaden offerings for payer customers in the hospital billing arena.
Founded in 2000, TC3 provides cost containment and loss control to healthcare payers on both a pre-payment and post-payment basis through its proprietary TruClaim suite of products that target fraud and waste. TruClaim services include rules-based fraud diagnostics and clinical code edit compliance, while the company’s CaseTracker software automates and manages investigations and other fraud management functions.
"TC3 is 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.” said Mike Dendy, President and CEO of AMPS. “We see our affiliation with TC3 as a perfect complement to our cost containment offerings.”
For its part in the deal, AMPS is a nationwide representative of payers providing a service that confirms accurate billing by hospitals for the services provided. The 15-year-old company states that its reviews of hospital claims yield an average cost savings of 19.75 percent over and above PPO discounts. The average claim size AMPS handles is roughly $65,500, which translates to an additional average reduction per claim of slightly more than $11,700.
"AMPS has an outstanding record [of] reviewing hospital claims accurately and fairly,” said Tim Huke, vice president of sales and marketing for TC3. “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 we feel AMPS will be of great value to our clients. TC3's affiliation with AMPS expands our integrated cost containment portfolio immensely."
Both companies have been active this year in both expanding their product offerings and in creating partnerships to broaden their customer bases. For TC3 the partnership with AMPS provides it with a greater reach into the hospital claims market. In addition, in June the company announced a partnership with Intelimedix to add its analytics and data mining expertise to TC3’s offerings.
And in March AMPS announced a per-employee/per-month (PE/PM) pricing program for employer groups of their TPA/payer clients.
"AMPS is a cost containment company and a PE/PM pricing model lends itself just as readily to our efforts as the typical percentage-of-savings model," said Mike Dendy, president and CEO of AMPS, at the time of the announcement. "Because of our physician driven audit and review model and our indemnification benefit, we feel confident enough in our outcomes to guarantee an outstanding return on investment to the employer group clients who work with our TPAs.”
