Infocrossing, Inc. (NASDAQ:IFOX), a provider of selective IT infrastructure, enterprise application and business process outsourcing services, today announced RA-Expert, a powerful new risk adjustment processing system. RA-Expert helps Health Plans to create, manage and submit the critical Hierarchical Condition Category (HCC) risk scores that drive claim reimbursement from the Centers for Medicare & Medicaid Services (CMS). When RA-Expert is used in conjunction with Infocrossing�s RECON+ payment reconciliation system, Plans also have access to specific financial analysis reports that determine whether or not data submitted to CMS is correct and that millions of dollars are not being lost. The Centers for Medicare & Medicaid Services (CMS) uses beneficiary encounter data captured through claims data and submitted by Medicare Advantage Plans to assign each beneficiary a risk score, which then is used to group patients into risk adjustment categories and assign payments based on the beneficiary�s condition. In addition to assuring the accuracy of risk adjustment data, Plans must assure that providers submit accurate and valid diagnosis codes. Incomplete or inaccurate data could cause Plans to receive lower reimbursements for their members. RA-Expert takes this health status data (HCC data files and submitted claim data) and creates a more accurate risk score for submission to CMS, with far fewer transactions processed. It does this by using HCC data to directly identify and focus on the highest possible risk score for each beneficiary so that there is no need to submit every claim transaction. Infocrossing�s complementary services help Medicare Advantage Plans collect and maintain complete and accurate risk adjustment data and submit it properly to CMS. Infocrossing RA-Expert lets Plans take control over the HCC management process and establish the most accurate baseline possible for both the annual submission deadline each September, and to plan for the year ahead. Without a risk adjustment processing system, plans are going day-to-day without the necessary internal processes to track HCC data and blindly submitting data to CMS. Infocrossing�s RA-Expert provides the most comprehensive process for managing and reporting each and every beneficiary�s HCC data and provides critical insight on what determines risk score so that Plans are not missing out on millions of dollars of CMS payments. Managing Risk Adjustments: Past, Present & Future RA-Expert also includes advanced analysis and financial reporting that, when paired with Infocrossing�s RECON+ payment reconciliation system for CMS capitation payments for Medicare Advantage, can recover significant lost money from inaccurate claim submissions. The RA-Expert financial reports flag unreported or under-reported encounter data for healthcare services provided to a beneficiary so that Plans can resubmit them to CMS. It allows Plans to readjust inaccurate beneficiary risk scores for up to three years retroactively and reclaim, in many cases, millions of dollars. �Even with our smaller Plans, Infocrossing is finding millions of dollars left on the table from inaccurate HCC data that resulted in under-payment for health services performed, and for one of our larger Health Plans, Infocrossing identified nearly $90 million owed from the last year alone,� said Art Miller, president of Infocrossing Healthcare Services. �We leverage years of experience working with Plans as the only third-party intermediary to CMS on risk scores, but the power of this added analysis and reporting manages the entire process of ensuring accuracy, retrieving past payment due and identifying patients that need more scheduled care.� The Infocrossing RA-Expert financial analysis reports help Medicare Advantage Plans understand their Medicare-enrolled population and track CMS-HCC assignment and capitated reimbursement as CMS maintains and adjusts risk scores�so Plans can calculate and recoup lost money both retroactively (for up to three years) and moving forward. Service highlights include: Analysis and comparison reports to identify potential errors or missing diagnoses Baseline generation of all available HCC and Risk Adjustment Processing System (RAPS) data for maximum historical risk identification for each member Analysis and comparison reports of prior years HCC data and RAPS submissions to current year RAPS submissions Up to date risk scores and expected payment for reporting years in our RECON system for up to three years And as a service provider with state of the art data centers across the nation, Infocrossing houses the data on its own customized, highly-secure IT infrastructure, removing the complexity and getting clients started right away. Infocrossing also provides technical assistance with services to help Plans manage complete and accurate risk adjustment data. Service highlights include: Data analysis reporting to identify potential issues Recommendations and assistance to implement a detailed corrective action plan Infocrossing Healthcare Services is exhibiting this week at the AHIP annual meeting and conference in Las Vegas (booth #1132) and will be introducing RA-Expert, as well as the Q/Advantage Medicare prescription drug coverage solution that the Company announced yesterday (see press release: www.infocrossing.com/news_events_newsroom.cfm). About Infocrossing Healthcare Services, Inc.�s Medicare Support Services Infocrossing Healthcare Services, Inc. provides managed care companies with an online, real-time system for reconciling CMS capitation payments. More than 150 managed care companies and pharmacy benefit organizations now use Infocrossing Healthcare Services, Inc.�s solutions. The Infocrossing Medicare Support Services are supported by Infocrossing�s five data centers located across the United States, which ensure the availability, scalability, reliability and redundancy of the offering. More information about Infocrossing Healthcare Services, Inc. can be found at www.infocrossing.com/healthcare. About Infocrossing (www.infocrossing.com) Infocrossing, Inc. (NASDAQ:IFOX, www.infocrossing.com) is a provider of selective IT infrastructure, enterprise application and business process outsourcing services delivering the computing platforms and proprietary systems that enable companies, regardless of industry, to process data and share information within their business, and between their customers, suppliers and distribution channels. Leading companies leverage Infocrossing�s robust computing infrastructure, skilled technical team, and process-driven operations to reduce costs and improve service delivery by outsourcing the operation of mainframes, mid-range, open system servers, networks and business processes to Infocrossing. Safe Harbor Statement This release contains forward-looking statements within the meaning of Section 21E of the Securities Exchange Act of 1934, as amended. As such, final results could differ from estimates or expectations due to risks and uncertainties, including, but not limited to: incomplete or preliminary information; changes in government regulations and policies; continued acceptance of the Company's products and services in the marketplace; competitive factors; closing contracts with new customers and renewing contracts with existing customers on favorable terms; expanding services to existing customers; new products; technological changes; the Company's dependence upon third-party suppliers; intellectual property rights; difficulties with the identification, completion, and integration of acquisitions; and other risks. For any of these factors, the Company claims the protection of the safe harbor for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995, as amended.
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