EDEN PRAIRIE, MN – This past June, executives from Ingenix and CareMedic Services took the time at the Healthcare Financial Management Association’s conference in Seattle to tout the growing influence of IT in cleaning up the revenue cycle management process.
Last month, they combined their efforts.
Ingenix, the Eden Prairie, Minn.-based subsidiary of the UnitedHealth Group, announced on Nov. 10 that it is acquiring St. Petersburg, Fla.-based CareMedic in an all-cash deal. Ingenix executives did not reveal the specifics.
Officials say the deal will allow Ingenix to offer an enterprise-wide platform that includes patient registration, eligibility verification, financial clearance, coding and compliance, bill submission, denials management and remittance processing.
“With CareMedic, we will transform RCM from a group of fragmented, claims-centric processes to a more comprehensive, patient-centric financial information management system,” said Bill Miller, Ingenix’s vice president of healthcare delivery. “The RCM systems available today lack interoperability between front-end and back-end functions, slowing cash flow and impeding a hospital’s ability to collect payment for services that have been provided. Our vision and combined capabilities will create a customizable enterprise-wide analytics solution for hospitals that seamlessly connects to other systems.”
With billions of dollars set to flow into the nation’s healthcare system through the American Recovery and Reinvestment Act of 2009 (ARRA) and Congress working to enact healthcare reform, providers are looking to leverage IT to improve operations on both the clinical and financial side. According to the American Hospital Association, hospitals lost almost $70 billion in 2007 due to faulty financial processes, including bad debt, uncompensated care and underpayment by commercial insurers and Medicare and Medicaid programs.
“Innovation and talent are key to solving healthcare’s biggest challenges,” said Andy Slavitt, the CEO of Ingenix. “We’re combining the great teams at CareMedic and Ingenix to deliver innovation with the common vision of simplifying the system, reducing waste and centering healthcare around the patient.”
CareMedic’s products include the electronic financial record (eFR) platform, designed to offer healthcare providers a real-time look at patient financial information across all departments of the hospital. Earlier this year, the company launched the Patient Access Management module, which integrates with Financial Admissions Clearance Tracking Software (FACTS) developed by the Cleveland Clinic to marry back-end financial functions with point-of-registration functions.
Ingenix officials plan to integrate the CareMedic platform with their INTELLIJET platform, which offers coding and compliance services and automated credit balance resolution. CareMedic will also enhance Ingenix’s business process outsourcing offerings with patient financial management services, accounts receivable management, secondary billing and denials recovery, among other managed services.
“With Ingenix’s expertise in reimbursement, health information management and consulting and our expertise in enterprise-wide RCM, we will create a unified solution that makes hospitals more efficient at managing cash flow and enhances our commitment to helping clients get paid,” said Sheila Schweitzer, CareMedic’s CEO. “As part of Ingenix, we will be able to provide clients with additional services and continued innovations that help them use capital more effectively and improve operational efficiency.”
