company info

Headquartered in Las Vegas, Nevada, with additional facilities in both California and Florida, the company’s clients include government payors (Centers for Medicare and Medicaid Services), large health plans and major employers. HDI is Medicare’s exclusive Recovery Audit Contractor in Region D (17 states & 3 U.S. territories). We have served as the National (all 50 states covered) Payment Error Rate Measurement (PERM) contractor for CMS since 2006. HealthDataInsights reviews annually over $300 billion in paid claims.
On December 16, 2011, HealthDataInsights (HDI) was acquired by HMS Holdings Corporation (NASDAQ: HMSY).

Company Overview

HealthDataInsights (HDI) is the industry leader in healthcare claims integrity: fraud, waste, abuse, errors and improper payment identification and recoupment solutions. Our customers include the public sector (the Centers for Medicare and Medicaid Services), and the private sector, including a number of the largest commercial payors in the United States.

HealthDataInsights is a technology-enabled healthcare services company that specializes in the identification and recoupment of claim overpayments to providers (hospitals, physicians, DME and other specialty providers.) The company, on behalf of its clients, employs sophisticated, proprietary software tools and database queries to retrospectively analyze 100% of a payor’s claims data. HDI currently reviews annually more than $300 billion in paid claims. The company’s technology—which is deployed retrospectively (post-adjudication, postpayment) — empowers a full review of all claims paid.

HDI was named to INC. Magazine 500 as one of the fastest growing companies in America two years in a row for 2007 and 2008.

"HDI’s combination of claims integrity experience, their demonstrated results, pay for performance model and superior technology clearly position HDI as the vendor of choice for both public and private healthcare payors"

The HDI Advantage

Experience

• 25+ years generating superior results for 
  commercial payor clients
• Sole focus is on healthcare
  claims integrity
• Technology supported results
• Industry leading Advisory Boards

Scope

• Complete Clinical Auditing Program
• $300+ billion claims data currently under
  audit
• National Medicare Recovery Audit 
  Contractor (RAC) - 17 states
• National Medicaid Payment Error Rate 
  Measurement (PERM) Contractor

Track Record

• $416 million of improper payments
  corrected during the Medicare RAC
  demonstration program.
• Strong Relationship with Providers
• Best Quality Results
• Ease of Implementation

Quality

• Clinical Expertise - key to accurate
  reviews
• Implementation Expertise
• Process Improvement
• Full Time Corporate Medical Director &
  Quality Management Team

Standards/Security

• Secure HIPAA compliant
• ISO 9001 Certified
• GSA Certified
• SAS 70 Type II Certified
• 24/7 full security at Data Center class
  “CoLo” facility

Performance

• Demonstrated ROI to Payors
• HDI is paid solely on results
• Unrivalled expertise in Medicare 
  and Medicaid claims
• Flexibility and dedicated HDI team