TC³ Health, Inc. (TC³) provides payer solutions that bridge the gap between internal claim management systems and external loss control programs to validate payment integrity and maximize healthcare cost containment savings. TC³ provides payers with a single source for multiple, pre-payment loss control services such as healthcare fraud detection, out of network claims management services and healthcare predictive modeling to reduce paid claims by 3-6% annually.

	Provider Integrity Program Thousands of data sources profile aberrant provider billing practices on a prepayment basis to prevent overpayments. Intelligent Claim Surveillance Employs dynamic profiling and predictive technologies using all available historical information to quickly identify complex fraud schemes. Case File Investigations TC³’s specialized team of investigators provide payers with thorough and defensible investigative reports. Code Edit Compliance Provides professional claims edit, audits and duplicate detection, including millions of nationally recognized sourced, documented and defensible rules based edits.		AccessPlus PPO Networks Allows payers to access over 700,000 providers nationwide to obtain PPO discounts on all out-of-network claims. Provider R&C Negotiations Proprietary data sets benchmarks are utilized to establish a reasonable reimbursement for both in network and out-of-network hospital, outpatient, ancillary and professional claims.		Predictive Modeling Financial and clinical early alert predictors to enhance risk management while profiling chronic diseases and potential catastrophic claimants. Plan Analyzer and Modeling Tool Project cost and impact of various plan design scenarios Web-Enabled Reporting Quick, reliable information dissemination that increases the speed and accuracy of decision making, enhancing plan performance through early identification of emerging trends.

TC³ provides health care payers with a total claims management solution that integrates internal claim management systems with external loss control programs. Utilizing our proprietary claims management system, the TC³ Funnel, we target $250 billion in healthcare claims overpayments to validate payment integrity and maximize cost savings for our clients.

Healthcare payers across the board are making healthcare cost containment a top-level priority as health care costs continue a six year trend of double digit annual increases. This trend is expected to continue through 2010. TC³ provides a proven, cost effective system which delivers reductions in claims payments by 3-6% annually.

Healthcare fraud detection tools are utilized to quickly identify complex fraud schemes on a pre-payment basis through dynamic profiling, predictive technologies, and proprietary databases.

Allowing payers to access over 700,000 providers nationwide to obtain PPO discounts reduces out of network claims costs. Further savings are realized through negotiations with Provider R&C's to establish reasonable reimbursement amounts for both in network and out of network hospital, outpatient, ancillary, and professional claims.

Healthcare predictive modeling offers financial and clinical early alert predictors to enhance risk management while profiling chronic diseases and potential catastrophic claimants. TC³’s proprietary modeling tool projects cost and impact of various plan design scenarios while a reporting system provides reliable information at the touch of a button.