FacilityClaim Insight®

FacilityClaim Insight®, from Verisk’s HealthCare Insight (HCI) unit, is a service that helps prevent fraud, abuse, and overpayment for healthcare facility claims. The service examines claims before payment. We’ve designed FacilityClaim Insight to maximize claims-payment accuracy, identify fraudulent activity, and reduce expenditures for facility claims.

FacilityClaim Insight combines:

• HCI’s Code Validator Pro® (rules-based) and Fraud Finder Pro® (profiling)  software systems
• claims-repricing software systems
• claims review by clinicians, AHIMA-credentialed examiners, and fraud specialists
• review of suspect facilities and providers by a Clinical Investigative Unit (CIU)SM
• fee negotiation by highly trained professionals

You get improved reserves and greater efficiency in identifying fraud.

For more information . . .

. . . about FacilityClaim Insight, visit the HealthCare Insight website, call us at 1-800-357-7781, or send e-mail to This e-mail address is being protected from spam bots, you need JavaScript enabled to view it .