Healthcare Data Management Announce Partnership with Renowned Advocates Carl Ginsburg and Mark Homonoff, M.D.
Healthcare Data Management has entered into a strategic business partnership with renowned health care advocates Carl Ginsburg and Mark Homonoff, M.D. to enhance audit opportunities and to provide specialized fraud and investigative analysis serving both the public and private sectors.
Intentional deception or misrepresentation of health care transactions by a provider, employer group, or member for the sake of receiving an unauthorized benefit or financial gain are on the rise in both public and private sectors. These wrongs bleed the system of over $100 billion a year, and for American employers health care fraud and abuse represent up to a 3-5% error rate in total claims. Additional errors, such as coding, misapplication, and incorrect benefit interpretation, cost employers a total in the 6-8% error rate range.
With state of the art auditing and data management services, HDM assists many of America’s leading employer groups with self-insured health plans in order to reduce costs and risks in the medical and pharmacy sectors. The detailed analysis and data mining provided by HDM’s BenefitsAudit, a retrospective audit utilizing 100% of the employer’s claims data, help to identify fraud and abuse within an employer’s claims and help provide critical assessments of performance issues, contract and plan compliance, and overpayments. When appropriate, Ginsburg and Homonoff will assist in the audit preparation and review when malfeasance issues are identified.
“This is a very unique and exciting opportunity for HDM to have two top professionals of this magnitude working along side with us to provide property utilization on identity and fraud when appropriate to our customers after we have completed the audits,” said David McSweeney, HDM’s Chief Operating Officer. “On the one side, we have New York-based Carl Ginsburg, who has reported on and advocated in behalf of injured individuals and groups, was a producer at NBC and CBS News, and remains to be one of the leading investigative reporters in the health care sector today, providing his in-depth health care expertise in combination with his legal background — while on the other side we now have Dr. Mark Homonoff, based in Washington, D.C., whose work with HDM follows his projects in finance for health and insurance at the national and international level and health care finance with brokerage and banking institutions, Dean Witter Discover, Wasserstein Perella, and Advest, Inc., contributing his international perspective to approaches to fraud detection in health. These two individuals constitute a strong addition to HDM and are a tremendous supplemental value to our HDM customers.”
About Carl Ginsburg
For more than 25 years, Carl Ginsburg has worked in the health care field as an investigator and writer. As a producer at NBC and subsequently CBS News in the 1980s and 90s, he covered courts, government agencies and business. Later, his investigative work took special aim at the health care sector. In 1996, Carl founded a research and public relations firm, CG Communications LLC, which has provided research on and strategic assistance to US companies and institutions -- their policies, practices and finances. CG Communications LLC has a diverse client base, including consumer groups, unions, and health care corporations.
About Mark Homonoff, M.D.
Dr. Mark Homonoff, a practicing physician, has worked at both the national level and international level in the areas of health care finance. This has included work in the establishment and operation of large scale health systems and insurance programs. His experience has encompassed the analysis of Medicare and Medicaid fraud and abuse, as well as the detection of fraud and corruption in the international arena. Besides institutional and case review, his work has incorporated economic analysis of the impact of policy changes in health, costs of changes in health care billing policies, and strategic approaches to issues of fraud and waste in health care.
Founded in 1992, Healthcare Data Management, Inc. (HDM) is a proven market leader in providing fully-integrated benefits analysis and financial reporting solutions specifically designed to reduce cost, manage risk and comply with Sarbanes-Oxley requirements to many of America’s leading employer groups with self-insured health plans, including Fortune 500 companies, government agencies, and labor groups. HDM offers employers a partnership in health care expense management and provides pioneering solutions customized by the employer’s data, procedures, and contracts. Solutions offered include BenefitsAudit, an electronic analysis that determines whether administrators are accurately adhering to their contractual obligations, benefit plan designs and financial agreements with providers, and BenefitsWatch, a robust analytical tool that generates vital information to successfully manage costs and risks in all areas of employee health benefits, including medical, dental, and prescription drugs. For more information, call 800-859-51190.