TC3 Health, LLC

Description

TC³ is a Premier Supporting Member of NHCAA, which was founded in 1985 by private health insurers and Federal/State law enforcement officials. Headquartered in Washington, D.C., NHCAA is an issue-based non-profit built upon the private-public partnership of organizations and individuals responsible for the detection, investigation, prosecution, and prevention of fraud against private and public health plans.

Founded in 2001, TC³ (Total Claims, Capture & Control ® ) provides healthcare payers with a total claims management solution that seamlessly and electronically integrates internal claim management systems with external loss control programs.

Our solution to discovering overpayments is leveraging our proprietary system driven analytics, algorithms, rules, and edits to provide detailed overpayment analysis. Coupled with our “human analytics” to validate findings, we then provide feedback on root cause analysis and process improvement.

In addition, TC³ helped ODS streamline their internal processes and reduce administrative work by electronically integrating with external data sources. ODS has remained a loyal customer for more than seven years due to TC³’s state-of-the-art technology, professionalism and commitment to customer service. We are pleased that ODS continues to retain TC³ as their long-term payment integrity partner.

IMX offers predictive healthcare analytics and actionable business intelligence solutions that identify, capture and reduce financial and medical risk, with particular focus on: cost containment, employer group reporting, outsourced analytics, data aggregation, and pharmacy cost management. The company’s customizable solutions can be implemented quickly and efficiently, with minimal programming. IMX is a privately held company operating on strategic investment from a consortium of Blue Cross and Blue Shield licensees called BP Informatics, LLC.

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