nTelagent's New Red Flag Compliance Tool Effectively Addresses the FTC's "Red Flag" Requirements for Healthcare Organizations

October 14, 2008 9:37 AM EDT

NASHVILLE, Tenn.--(BUSINESS WIRE)--

Today nTelagent, Inc. announced that its new "Red Flag Compliance Report" helps hospitals and other healthcare service providers to effectively address the Federal Trade Commission's new "Red Flag and Address Discrepancy Rules," which become mandatory November 1, as well as other federal healthcare regulations. The Red Flag Compliance Report is an important component of nTelagent's Self-Pay Management System (SPMS), The Retail Application for the healthcare industry. Similar to applications used in the retail industry at the point of sale, the company's proprietary, automated system tells healthcare registrars and financial counselors exactly what to do and what to say to each patient at the point of service regarding financial responsibilities.

According to nTelagent chairman and CEO Earl T. Winter, "Our SPMS technology already is helping healthcare organizations across the country to meet and monitor compliance efforts, specifically addressing the important new Red Flag Rules. With SPMS implemented, providers can monitor in real-time compliance at a system-user level and a patient level." The regulations from the FTC are anti-identity theft, consumer protection rules, encompassing a wide range of financial institutions and creditors, including many healthcare service providers. Healthcare organizations falling under the rules must develop and implement a written Identity Theft Prevention Program, with the goal of detecting, preventing and mitigating medical identity theft in connection with new or existing covered accounts.

Visit www.ntelagent.com to download the just-published white paper titled "Effectively Addressing the New 'Red Flag' Requirements and Other Federal Healthcare Regulations" for more on these issues.

nTelagent's SPMS addresses the Red Flag Rules on two fronts. First, the system helps providers lessen the risk of identity theft from the outset, because, unlike some systems, SPMS does not collect or house vulnerable data elements such as credit reports/scores, Social Security numbers or dates of birth to verify patient identity or to determine patient capacity to pay. Instead, SPMS incorporates the patient's biographical data with publicly available, in-depth demographic information, using only a person's name and address to verify patient information. By using and storing this less-sensitive data, patient information is protected and is not as valuable to either internal or external identity thieves.

Second, SPMS allows patient access staff to immediately verify and validate patient identity at the point of service, reducing the risk of fraudulent activity. Verification of a patient's identity, as well as his or her capacity to pay for services, is delivered to patient access staff in a matter of seconds, with no need for the paper-based proofs of identity of yesterday. The database returns the most recent recorded address for the guarantor, not a list of addresses that the individual has used in the past. The system alerts the registrar or financial counselor to any red flags regarding patient identity or fraudulent activity, and instructs them in how to handle the patient encounter. In addition, the Red Flag Compliance Report alerts administrators and/or managers of potential fraudulent activity within the organization.

Winter continues, "Without this real-time verification of identity, providers automatically open themselves up to fraud and the possibility of medical identity theft. If a healthcare facility can not absolutely prove that individuals are who they say they are, there can be major negative consequences: people using multiple identities or insurance information that doesn't belong to them, the possibility that charity care and government assistance programs are not being properly allocated, not to mention inaccurate medical records and the chance that a person receives incorrect medical treatment. Our Red Flag Compliance Report helps providers avoid these problems in a cost-effective, efficient manner."

The FTC estimates that 8.3 million people were victims of identity theft in 2005. Some 3% of them, or about 250,000 people, were victims of medical identity theft. Many of these cases were a result of fraudulent activity within a healthcare provider's organization.

About nTelagent, Inc.

nTelagent, Inc. has developed The Retail Application for the healthcare industry, called the Self-Pay Management System (SPMS). Similar to applications used in the retail industry at the point of sale, the company's proprietary, automated system tells healthcare registrars and financial counselors exactly what to do and what to say to each patient at the point of service regarding financial responsibilities. Moving workflow to the front end of the revenue cycle, nTelagent helps providers ensure a better patient experience through clearer communication and better handling of patient accounts, while improving upfront and overall cash flow, receivables and profitability by reducing bad debt. Using non-credit scoring data, SPMS provides interactive scripts that integrate patient demographic information with each provider's business policies and rules. The system allows for price transparency and automatically identifies discounting options, social services eligibility and charity care options when applicable, ensuring that patient financial accounting--for both insured and uninsured patients--is handled appropriately and consistently. Visit www.ntelagent.com for more information.

Source: nTelagent, Inc.

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