Carewise Health Announces New Payment Integrity Client and Initiative

May 06, 2014

Carewise Health announced today that their long-standing Medical Bill Review business unit has been renamed Payment Integrity and adopted the QEC (Quality, Efficacy, Costs) analytics model as their “front end” case identification and stratification tool. QEC provides proprietary algorithms that identify those large hospital and ambulatory cases more appropriate for nurse audits, and more likely to yield results. This tool is highly valuable to both health plans and providers in ensuring accurate and appropriate payment of services.

In announcing this initiative, Cheri Moehring, Carewise Payment Integrity and Chuck Bloss, Lead Actuary, Healthcare Analytics Services Holdings Inc. (HAS) indicated that QEC would be applied to all new and existing Carewise clients. Ms. Moehring commented “We believe a more predictive analytics tool at the front end of our nurse clinician audit efforts will yield better results for both providers and payers, and ensure that changes to any payments are valid.”

About Carewise Health, Inc.
Carewise Health uses the most experienced nurse clinicians to carry out our Clinical Care Management and Payment Integrity services to customers. They are backed up by data and behavioral scientists, engineers and information technologists to ensure they are using the most reliable data and the most advanced technology to support their efforts. Carewise Health has the experience to manage large, complex customers. Carewise Health has one of the largest data repositories and hubs to use in creating unique models and algorithms in support of our products and services. Visit for more information.

About Healthcare Analytics Services Holdings, Inc.
Healthcare Analytics Services Holdings, Inc. offers large, complex customers high value services and products. They offer four standard commercial analytic models and customized models using our data and behavioral scientist to design a unique analytic framework and model to meet a specific business inquiry. The company evolved from the ground-breaking modeling, mathematical and analytical work developed by a team of actuaries, data and behavioral scientist and key technology vendors.

Kevin Scarborough

Chief Administrative Officer

Carewise Health, Inc.