BenefitsEmployee Engagement

SHPS Deploys Fair Isaac Blaze Advisor to Revolutionize Healthcare Spending Accounts Through Automated Business Rules Decisions

LOUISVILLE, Ky.–(BUSINESS WIRE)–Nov. 7, 2005–SHPS, a leading provider of spending account services to large employers, the federal government and health carriers, announced a new partnership with Fair Isaac Corporation, a leading provider of analytics and decision- management technology. Under the terms of the contract, SHPS will use Fair Isaac Blaze Advisor business rules management software to process and approve spending account and health reimbursement arrangement (HRA) claims.

Spending accounts allow employees to set aside pre-tax dollars to pay for certain expenses not covered by their health plans, including healthcare, dependent care and commuter expenses. HRAs are tax-advantaged, employer-funded accounts that employees use to pay for healthcare expenses.

SHPS’ integration of Fair Isaac’s rules management technology and universal decision engine, Blaze Advisor, cuts SHPS’ claims processing time in half, allowing SHPS to process and pay a large percentage of claims on the day they are received and reduce average claim processing time to less than four days. The automation also establishes a processor-independent method for claims review, ensuring consistency and reducing the need for manual claims quality review.

SHPS’ use of Blaze Advisor is a first for the spending account claims processing environment, where claim review prior to reimbursement is required under strict Internal Revenue Service regulations. Additionally, implementing Blaze Advisor gives SHPS the ability to effortlessly and precisely introduce client-specific spending account rules as well as regulatory-driven rule changes.

"Blaze Advisor fits perfectly with SHPS’ overall technology strategy of being the market leader for providing maximum flexibility to clients, while maintaining a high-quality, compliance-driven, and participant-focused service," said Rishabh Mehrotra, SHPS’ president, human resource services and chief technology officer. "Blaze Advisor gives SHPS unrivalled customization and rapid deployment capabilities."

Blaze Advisor will also be used to process and approve spending account debit card transactions, enabling SHPS to provide guaranteed auto-approval rates on card transactions of 85 percent or higher.

"The use of Blaze Advisor will alleviate the strain of manual claims processing, and speed SHPS’ review with almost total automatic adjudication through a series of non-technical rules," said Mark Layden, vice president and general manager of Enterprise Decision Management technologies at Fair Isaac. "Blaze Advisor’s powerful and intuitive business language helps users of all types troubleshoot problems and customize solutions while maintaining quality standards."

Complex legislation, rising healthcare costs and employee demands for the newest benefit options challenge human resource departments to keep workers satisfied while managing healthcare costs. With Blaze Advisor, SHPS has developed a revolutionary spending account system to better serve its clients, reduce administrative and processing costs, all while giving employees a better benefits experience.

"Blaze Advisor is a highly-innovative and beneficial tool – one that offers many strategic advantages to SHPS’ products. We are already incorporating the application into our suite of health management products, where it will play an even larger role in improving the employee healthcare experience and reducing the overall cost of healthcare for both employers and employees," said Mehrotra.

About Fair Isaac

Fair Isaac Corporation (NYSE:FIC) is the preeminent provider of creative analytics that unlock value for people, businesses and industries. The company’s predictive modeling, decision analysis, intelligence management, decision management systems and consulting services power billions of mission-critical customer decisions a year.

Founded in 1956, Fair Isaac helps thousands of companies in more than 60 countries acquire customers more efficiently, increase customer value, reduce fraud and credit losses, lower operating expenses and enter new markets more profitably. Most leading banks and credit card issuers rely on Fair Isaac solutions, as do insurers, retailers, telecommunications providers, healthcare organizations and government agencies. Through the www.myfico.com Web site, consumers use the company’s FICO(R) scores, the standard measure of credit risk, to manage their financial health. For more information on Fair Isaac Blaze Advisor, visit www.fairisaac.com/rules.

About SHPS

SHPS provides consumers and corporations a single source of health management decision guidance through its Integrated Health Management approach. Its innovative CareWise(R) brand offers comprehensive care, plan, spending, productivity and strategic management services that help guide employees to be healthier and more productive. SHPS serves employers, health plans, hospitals and governments, and has more than

85 Fortune 500 clients. The company employs more than 2,200 nurses and health professionals, employee benefit specialists and IT experts in facilities across the United States. Visit www.shps.com.

CONTACT: SHPS, Louisville

Susan Dixen, 502-297-5269

susan.dixen@shps.com

 

Tags: Benefits, Engaged Workforce, HRO Today Global

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