Suffolk County RFP – To Provide Fraud and Abuse Prevention Plan Services for the Department of Health Services.

The Chief Purchasing Agent for Suffolk County, New York announced that the Allied Management Group (AMG)…”has been selected by the RFP Evaluation Committee as the apparent successful proposer for the above referenced Request for Proposal.” Suffolk County and AMG have agreed to contract terms. Services will be deployed following receipt of a signed contract. As of 2006 the State of New York has a total of 4,208,629 MediCaid recipients, of which 2,572,242 are enrolled via managed care plans. Suffolk County has a significant MediCaid enrollment to manage and/or monitor. AMG will provide the tools and service to manage this responsibility.

Employees at AMG-SIU take classes at local colleges and universities, including prestige institutions such as the Extension Unit of the University of California, Irvine (UCI).

AMG-SIU has doubled their office space and hired additional staff over the last quarter as a response to the high demand for their SIU services.

One of AMG-SIU’s clients has been ranked one of  “100 best places to work in IT”. The list has been published by Computerworld.

AMG-SIU saved one of their clients $210,000 by performing an audit on DRG usage. The audit uncovered that many providers were using wrong DRG codes for newborn babies. Correcting the affected claims saved the health plan over $210,000.

In an article called “Slicko“, Forbes reports that most health insurances spend about 20% too much on medical claims due to fraud, waste and abuse.
In their opinion, this is a bigger problem than the wrongful denials mentioned by Michael Moore in his movie “Sicko”.
AMG-SIU discovers lots of problems in different areas, including ineligible members, not covered services and duplicate claims mentioned in the article.
AMG-SIU not only ensures the accuracy of edits, but also provides backup for their denials.

The Federal Bureau of Investigation (FBI) was thanking AMG-SIU for their support (letter from the FBI). The FBI is also looking forward to combating healthcare fraud in cooperation with AMG-SIU.

The International Association of Software Architects published an article by Abhijit Gadkari, one of AMG-SIU’s Enterprise Architects. His article “The extended Application Service Provider Service Model” can be found in the December 2006 issue of the “Perspectives of the IASA” magazine.

According to the annual HMO Complaint Data report published by the Office of Public Insurance Counsel, AMG-SIU’s clients receive the fewest complaints from patients and providers. All of our clients received top rankings and had far fewer complaints per 10,000 enrollment than most other HMOs.

AMG-SIU doubles its business by taking on new clients and expanding the number of services for existing clients.