NEW YORK, Oct. 8 /PRNewswire-FirstCall/ -- Health Management Systems, Inc. (HMS) today announced that it has acquired the business of Peer Review Systems, Inc. d/b/a/ Permedion, an independent health care quality review and improvement organization based in Westerville, Ohio. With this acquisition, HMS augments its portfolio of program integrity and coordination of benefits service offerings for state Medicaid agencies and managed care organizations.
Permedion utilizes advanced data mining algorithms based on over 30 years of experience in Medicare and Medicaid claims review for coding/billing and medical necessity. The company's staff includes a Medical Director, registered nurse reviewers, certified coding specialists, biostatisticians, epidemiologists, data analysts, and a nationwide network of over 400 physician reviewers. The company is accredited by URAC (Utilization Review Accreditation Commission) in both Independent Review and Utilization Management and has been designated by CMS as one of eight Qualified Independent Contractors (QIC) in the United States.
Permedion provides independent external medical review on issues of quality of care, medical necessity, and experimental/investigational treatment to both state government and private clients across the country. The company works with government agencies, including Medicaid, Medicare, State Insurance Departments, and Correctional Departments, to help ensure that services are billed appropriately, and that the care provided is of the highest quality.
"One of the largest components of waste and abuse in the Medicaid program involves payment for services that were either not provided as billed or were not medically necessary," said Bill Lucia, President of HMS. "Permedion's clinical review expertise offers HMS's clients increased opportunity to reduce unnecessary costs."
Tom Schultz, President of Permedion, added, "As a part of HMS,
Permedion is perfectly positioned to expand i
|SOURCE Health Management Systems, Inc.|
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