HMS

Lorica Health is a healthcare technology company that specializes in advanced claims analytics solutions and services for the healthcare sector. Established in 2011 as CMC Insurance Solutions, it emerged from research conducted by the Capital Markets Cooperative Research Centre, a significant research and development entity founded in 2001. Lorica Health focuses on providing data analytics services tailored to the health insurance industry, including consulting practices, payment integrity, and clinical coding and billing audits. By leveraging its analytical capabilities, the company aims to enhance operational efficiencies and improve decision-making within the healthcare landscape.

MedAdvisor is a digital health company specializing in medication management solutions. It develops software platforms that connect healthcare professionals with patients, promoting adherence to prescribed medications through mobile and web technologies.

VitreosHealth, Inc. specializes in predictive analytics and risk stratification for population health management. The company offers a suite of tools, including population state-of-health analyzers and performance optimization modules, designed to improve cost and quality in both ambulatory and acute care settings. Through its innovative Insights-as-a-Service model, VitreosHealth provides healthcare providers and payers with actionable insights that help identify high-risk patients, manage care effectively, and measure the financial impact of care management programs. By utilizing a comprehensive array of data sources, such as electronic health records, claims data, and socio-economic factors, VitreosHealth enables organizations to deliver patient-centric care and achieve better health outcomes. Founded in 2009 and based in Plano, Texas, with operations extending to India and partnerships with major healthcare advisory firms, the company serves clients across multiple countries, including the United States, the United Kingdom, and Australia.

Eliza Corporation blends technology, communication expertise, and data analytics to drive healthy behavior change. The company's intelligent, tailored interactions-including automated calls-make health and healthcare information more accessible, more actionable, and more engaging. Each program is powered by Eliza's patented speech recognition technology, rich web and multi-modal delivery platform, population profile analysis, and Continuity of Care Record (CCR) capabilities. These programs consistently yield the best outcomes in the industry in terms of improved engagement, health and wellness measures, and financial savings. Eliza's customers include the nations leading health plans, disease management firms, pharmaceutical companies, pharmacy benefit managers and employers. The results of Eliza's programs have been recognized by organizations including the Centers for Prevention and Disease Control, the BlueCross BlueShield Association, URAC, Entrepreneur magazine, The Consumer Directed Health Care Congress and Harvard Medical School.

Essette is a provider of web-based care management software designed to enhance the delivery of healthcare services. The platform offers a user-friendly and powerful alternative to traditional applications, enabling healthcare organizations to efficiently manage population health and facilitate collaborative care. Essette's solutions support real-time monitoring and reporting of data, integration with core systems, and engagement with various external electronic medical records. The company emphasizes the importance of combining technology with innovative thinking to deliver high-value care, ensuring that providers have the tools needed to effectively coordinate care teams and manage multiple data sources. With a commitment to integrity and excellence, Essette is becoming a preferred choice among healthcare organizations seeking comprehensive and integrated care management solutions.

MedRecovery Management specializes in workers' compensation recovery services, focusing on identifying and recovering improperly paid funds within the business industry. Employing advanced data mining techniques, the company systematically analyzes claims to uncover potential overpayments, ensuring that clients can reclaim financial resources efficiently. MedRecovery Management's expertise in this niche sector positions it as a crucial partner for organizations seeking to optimize their workers' compensation processes and enhance their financial recovery efforts.

HealthDataInsights, Inc. is a technology-enabled healthcare services company that focuses on identifying and recouping fraud, abuse, and overpayments for government payors, health plans, and employers. The company specializes in detecting overpayments to various healthcare providers, including hospitals, physicians, and durable medical equipment suppliers. HealthDataInsights offers a range of solutions, including MyHealthCompass, a web-based resource providing quality and financial information on providers; Financial Compass Plus, a database and software solution for financial and operational metrics; and Clinical Compass Plus, a desktop tool for healthcare decision-makers to analyze and present clinical data. Additionally, HealthDataInsights serves as a recovery audit contractor. The company is headquartered in Las Vegas, Nevada, with operational facilities in Newport Beach, California, and Orlando, Florida.

Chapman Kelly provides dependent eligibility audits to large, self-insured employers, as well as plan and claims audits to both employers and managed care organizations.

Allied Management Group Special Investigation Unit, Inc. provides fraud, waste, and abuse prevention solutions for healthcare companies, health plans, and government agencies in the United States. The company provides services in the areas of fraud, waste, and abuse compliance creation and management; Automated Claims Evaluator (ACE), a forensic editing solution for medical claims; and Automated Investigation Management System, a fraud, waste, and abuse investigative tracking system.

Verify Solutions, LLC provides professional audit services for employers. The company’s services include dependent eligibility reviews and human resources data reviews. It also audits and updates an employer's human resource database, as well as assist in gathering the data to meet EEOC reporting requirements.

IntegriGuard, LLC provides medical record reviews, financial reviews, and education activities for benefit programs and payment systems in the United States. The company offers audit, investigation, medical review, data aggregation and analysis, enrollment and eligibility verification, training, and compliance services. It serves Centers for Medicare & Medicaid Services, the U.S.

Prudent Rx, Inc. specializes in providing comprehensive audit and consulting services to the pharmaceutical industry. The company offers a range of services, including pharmacy audits, facility site reviews, and evaluations of proposals and vendors. Additionally, Prudent Rx focuses on prior authorization programs and assists clients with the development of custom requests for proposals, as well as the analysis of plan design and performance. Their expertise extends to rebate audits and formulary reviews, allowing them to deliver tailored solutions that enhance pharmacy benefit management for their clients.

Permedion is an independent health care quality review and improvement organization based in Westerville, Ohio. The company specializes in providing independent utilization and external medical review services to state government and private clients throughout the United States. Permedion's offerings include utilization management solutions such as prior authorization, precertification, concurrent review, and retrospective review services. By focusing on ensuring that both inpatient and outpatient services are medically necessary, billed appropriately, and of the highest quality, Permedion plays a crucial role in enhancing health care delivery and maintaining standards within the industry.