Morning Briefing: New deal to cut health claims errors

New deal to cut health claims errors... Industry stalwart joins Fifth Third Bancorp... Robots to reduce risk... Express Scripts’ pricing bitter pill for Anthem to swallow...

by Richard Brown

New deal to cut health claims errors
Errors in processing healthcare claims will be greatly reduced if a new pact between two leading specialists in the field delivers on its promise.

Health services firm Optum and Availity, a real-time health information network, are to join forces in a bid to boost the accuracy of health insurance claims and cut processing errors and appeals. Optum is a unit of UnitedHealth Group.

Some 900,000 care providers in the U.S. who use practice-management systems to exchange real-time administrative, financial and clinical information with government and commercial health plans nationwide are set to benefit from the initiative. Availity’s volume of transactions across its network will rise to 3 billion.

Industry stalwart joins Fifth Third Bancorp
Howard McClure, a 30-year veteran of the U.S. insurance industry, has joined Cincinnati, Ohio-based Fifth Third Bancorp as senior vice president and head of insurance services. He will report directly to Lars Anderson, chief operating officer.

McClure previously served as president of Palmer & Cay of Texas, following a stint leading Wells Fargo’s Southwest region and heading a major part of Wachovia’s insurance business. He also worked at Chubb Insurance’s Financial Institutions group, with responsibility for the Pacific and Asia regions.

In his new post, McClure he will help develop a holistic insurance strategy, including exploring alternatives to expand the bank’s insurance offerings and employee benefits for the consumer and commercial lines of business.
Robots to reduce risk
Artificial intelligence could drastically reduce insurance risks if proponents of AI’s benign benefits are to be believed.

Speaking at a panel during the opening day of the World Economic Forum in Davos, Switzerland, Ya-Qin Zhang, president of Chinese search engine Baidu, said applied to insurance and loan underwriting, AI can better assess risk.

Said Zhang: "In insurance and consumer loans, A.I. and machine learning can help you identify all the patterns to help you reduce risk," Bloomberg reported.

AI researchers Andrew Moore, dean of the School of Computer Science at Carnegie Mellon University, and Stuart Russell, professor of computer science at the University of California, Berkeley agreed that AI is set to vastly improve lives over the next 10 years. 
Express Scripts’ pricing bitter pill for Anthem to swallow
The ongoing spat between Express Scripts Holding Co. and its largest client, health insurer Anthem Inc., is proving hard on the former’s stock price.

Anthem Chief Executive Joseph Swedish slammed pharmacy benefit manager Express Scripts for price gouging his firm by over $3 billion a year.

Bloomberg reports that Anthem could save at least 10 percent on its annual drug bill by crafting a new deal with Express Scripts, Goldman Sachs Group Inc. analyst Matthew Borsch wrote in a note to clients. Since Swedish’s comments on Jan. 12, Express Scripts’ stock has fallen as low as $69.04, or 19 percent, compared with the S&P 500 losing only 6.5 percent. 
Aspen to grow agricultural insurance business
AgriLogic Insurance Services has been bought by Aspen Insurance Holdings Ltd in a bid to develop a US agriculture insurance platform for the global (re)insurer. Based in Kansas, AgriLogic is a specialist U.S. crop business with an integrated agricultural consultancy and estimated gross written premiums of $185 million in 2015.

AgriLogic’s President & CEO Joe Davis will maintain his role, reporting to Brian Boornazian, Chairman, Aspen Re. AgriLogic will be folded into Aspen’s existing reinsurance operations, led by Michael Dicker, Group Head of Agriculture. Aspen wrote $2.9 billion in GWP in 2014.

Kentucky names Maynard commissioner
Kentucky Department of Insurance has named Brian Maynard its new commissioner. He replaces Sharon P. Clark who had held the post since 2008.

A contract examiner for the state for 12 years, Maynard was previously with INS Regulatory Insurance Services, covering state insurance authorities in from Delaware to Texas. Prior to his latest appointment, Maynard acted as SVP of accounting at New Era Life Insurance Co., and held influential roles at The Freedom Group, the Life Insurance Company of the Southwest and United Group Insurance Companies.
Serial scammer nabbed for auto fraud  
Salt Lake City authorities have finally foiled fraudster Navid Monjazeb’s auto scrapes and japes by arresting the cheat on 22 counts of insurance fraud. Monjazeb, who had swindled over $55,000 from insurance companies during the past five years, would entrap victims into admitting liability for car accidents he created. The state’s Insurance Fraud Division had been tailing Monjazeb for six months.

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