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Fact Sheet
First Health Services Corporation
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First Health Services
Corporation (Services), a subsidiary of First Health
(NASDAQ:FHCC), is a health care management and information
services company that works exclusively in the public
sector. Services works to meet the needs of state Medicaid,
pharmacy, pharmaceutical assistance, mental health,
long-term care, and other health care programs. |
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Headquartered in Richmond,
VA, Services provides clinically based services that
are designed to promote quality care by integrating
health care-management programs, innovative technology
and cost-effective solutions tailored for each state.
Currently, the company provides services to agencies
in 32 states, handling more than 200 million claims
for more than 20 million consumers. |
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First Health Services
Corp., originally founded in 1968 as The Computer Company,
has been a pioneer in the Medicaid and public sector
health care industry, developing some of the nation's
first computerized Medicaid Management Information Systems
(MMIS). |
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With more than 30 years
of experience developing and operating some of the country's
largest MMIS medical claims processing systems, Services
is uniquely qualified to serve states as their fiscal
agent. |
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As a fiscal agent in
three states, Services:
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Processes more
than 33 million claims for more than 1.3 million
eligible recipients each year. |
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Offers multiple
managed care activities, including data capture,
claims resolution and payment, imaging document
management, electronic data interchange and federal
and state reporting as well as managed care enrollment
broker services. |
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Services is a national
leader in pharmacy benefit administration (PBA) services
for public sector clients, including both Medicaid and
state pharmaceutical assistance programs for senior
citizens and the disabled. The goal is to improve program
and patient outcomes as well as lowering the rate of
growth of pharmacy costs by improving drug utilization
through expert clinical management and support services.
PBA services include:
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Clinical care
management, including prospective and retrospective
drug utilization review, prior authorization,
provider profiling and disease state management
services as well as the development of preferred
drug lists and the negotiation of supplemental
rebates with pharmaceutical manufacturers. |
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POS claims administration
of more than 168 million claims for more than
7 million members annually. |
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Administration of
Standard and Supplemental CMS Rebate programs including
collection rates above the national average, fast
turnaround on cash flow, and efficient dispute resolution.
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Effective data analysis
and decision support, including the ability to produce
immediate reports, determine trends, assess high
use/overuse of drugs, establish interventions and
track their impact. |
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Member and provider
services, including "Help Desk" availability
24/7/365 staffed by trained technicians or pharmacists
able to handle inquiries regarding clinical issues,
prior authorization, member eligibility and drug
pricing. |
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Services provides state
Medicaid clients with a variety of clinical-based Health
Care Management (HCM) services focused on increasing
quality and access to appropriate services while helping
to ensure integrity of program policy and financial
resources, including:
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First Health Services,
through its Centers for Medicare & Medicaid Services
(CMS)- certified peer review organization (PRO)-like
status, can offer states the ability to receive 75 percent
federal financial participation (FFP) reimbursement,
instead of the standard 50 percent, for certain utilization
management and utilization review services. |
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More information can be found
on the company website at www.fhsc.com. |
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