NASHVILLE, Tenn. – Emdeon, a leader in revenue and payment cycle solutions, announced today the signing of an agreement to acquire substantially all of the assets of The Sentinel Group from Optimal Business Services, Inc., a subsidiary of Trustmark Mutual Holding Company (Trustmark Companies). The Sentinel Group is a recognized leader in healthcare fraud and abuse management services. The acquisition is subject to customary closing conditions and is expected to close in the second quarter. Specific terms of the agreement were not disclosed.
The Sentinel Group combines sophisticated data analytics solutions and technology with a highly experienced team of fraud investigators. During nearly 19 years of conducting investigations, The Sentinel Group and its employees have achieved a strong track record of cost savings for customers.
"We are delighted about this opportunity and the benefits it will bring to our customers," said George Lazenby, Chief Executive Officer of Emdeon. "Billions of dollars are lost every year to healthcare fraud, and that drives up costs for patients, doctors, hospitals, insurers, employers and ultimately U.S. taxpayers."
"Emdeon is the single largest financial and administrative information exchange in the U.S. healthcare system," said Lazenby. "By integrating The Sentinel Group’s technology and intelligence into Emdeon’s existing workflow, we have the opportunity to generate tremendous savings for both the public and private sectors."
According to the National Health Care Anti-Fraud Association (NHCAA), U.S. healthcare spending in 2007 topped $2.26 trillion. The NHCAA and the Federal Bureau of Investigation (FBI) estimate that 3% to 10% of all healthcare spending – or between $68 billion and $226 billion – is lost to fraud each year.
More and more states are taking action to fight healthcare fraud. At least 41 states have set up fraud bureaus to identify and investigate fraud. In 21 states, insurers are required by law to set up specific programs to identify insurance fraud and outline actions to reduce fraud.
"Right now, healthcare costs and their impact on the economy are top priorities across our nation," said Gary Stuart, Executive Vice President at Emdeon. "Emdeon’s mission is to make healthcare more efficient. Now we will have another way to help make payments more efficient – and take costs out of healthcare – during a critical time for the healthcare industry and our economy."
The acquisition will expand Emdeon’s portfolio of offerings to help identify potential financial risks much earlier in the claims administration cycle, creating efficiencies and cost savings for payers and providers alike. Emdeon’s network connects 1,200 government and commercial payers, 340,000 providers, 5,000 hospitals, 77,000 dentists and 55,000 pharmacies. The breadth and scale of this network allows Emdeon to drive consistent workflow, information exchange and risk management for all healthcare constituents.
"We are very excited to become a part of the Emdeon family," said Kelli Garvanian, Vice President of The Sentinel Group. "We look forward to working together to create new opportunities and be part of the solution as our nation tackles healthcare costs and reforms," she said. Following the closing of the transaction, Garvanian will join Emdeon as its Fraud and Abuse Product Champion.
The Sentinel Group evolved from an internal competency within the Trustmark Companies’ employee medical benefits divisions. As part of this transaction, the Trustmark Companies will remain long term customers of The Sentinel Group. "It’s very much a win-win situation. Our customers will continue to receive excellent value from a premier healthcare anti-fraud company. Emdeon, through its connectivity and vast network, will be able to make The Sentinel Group’s intelligence database stronger, resulting in improved savings for all customers," said Dave McDonough, Chief Executive Officer of the Trustmark Companies.
"Ultimately, this transaction is about creating safeguards much earlier in the healthcare payment process – helping our customers improve payment integrity and cash flow," Stuart said. "Our customers do not need another partner - they need one partner that does more."
About The Sentinel Group
The Sentinel Group is a division of Optimal Benefits Services, Inc., a Trustmark Company, based in Lake Forest, Illinois. The Sentinel Group, a recognized leader in the healthcare anti-fraud and abuse industry, has one of the most experienced teams of fraud investigators in the industry and is supported by sophisticated, state-of-the-art technology and years of in-depth intelligence gathered nationwide from healthcare providers.
Through its subsidiaries and operating divisions, Trustmark provides access to a full spectrum of employee benefit solutions, including benefits administration, voluntary and group medical benefits, and healthcare management programs. The success of each Trustmark Company is based on building and maintaining trust through personal, responsive service and flexible benefit products. Visit http://www.trustmarkcompanies.com/.
Emdeon is a leading provider of revenue and payment cycle solutions that connect payers, providers and patients to integrate and automate key business and administrative functions throughout the patient encounter. Through the use of Emdeon’s comprehensive suite of products and services, its customers are able to improve efficiency, reduce costs, increase cash flow and more efficiently manage the complex revenue and payment cycle process. Emdeon is owned by General Atlantic LLC and Hellman & Friedman LLC. For more information, visit http://www.emdeon.com/.
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