25.06.2007 14:21:00
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Sun Life Financial Selects The Sentinel Group's Anti-Fraud Services For Stop-Loss Customers
Adding to its extensive array of cost-control features, the Employee
Benefits Group division of Sun Life Financial U.S. (NYSE: SLF, TSX:SLF)
announced it has selected The Sentinel Group to offer optional medical
fraud and abuse detection services to its Stop-Loss insurance customers.
Stop-loss insurance helps employers protect their self-funded healthcare
plans from unexpectedly high claim costs.
"After an extensive review process, we
selected The Sentinel Group for their leadership in fraud detection and
prevention,” said Christopher C. Brown, Vice
President, Stop-Loss at Sun Life Financial. "With
healthcare costs higher than ever, it’s become
crucial for employers to do everything they can to avoid paying
fraudulent and abusive claims. Reducing fraud keeps healthcare costs
lower for everyone.” At least 3% of annual
healthcare costs, or $60 billion, are lost to fraud.1
Effective immediately, Sun Life Financial’s
Stop-Loss customers can access The Sentinel Group’s
services, including:
Data modeling: Claims data is used to build custom models, enabling
suspicious invoicing and possible fraud tactics to be scored and
uncovered.
Claim Investigation: Should a claim warrant closer review, Sentinel’s
investigators are available to provide direction on whether the claim
should be paid, and will monitor the healthcare provider’s
future invoices.
The Sentinel Group has a large staff of investigative talent, with a
broad array of experience, including clinical and criminal justice
backgrounds. It boasts the most intelligence on healthcare providers in
the industry, and utilizes state-of-the-art technology and data
resources in its investigations.
"At The Sentinel Group, we are committed to using the most advanced
technology and employing a highly-skilled staff on behalf of our
customers. We strive to generate unparalleled savings in the industry,
minimize disruption and ensure that healthcare providers are paid what
they are owed and not a penny more,” said
Julie M. Malida, F.S.A., M.A.A.A. and President of The Sentinel Group.
The Sentinel Group’s services are the latest
additions to Sun Life’s SunResourcesSM
program. SunResources targets employers’
biggest healthcare expense challenges, such as hospital bills, claims
subrogation and invoicing. The program links employers to vendors and
services that can address these challenges and help lower the total cost
of employee health care. SunResources is available to Sun Life Financial’s
stop-loss customers and their Third Party Administrators at no
additional cost.
1 National Health Care Anti-Fraud Association,
"The Problem of Health Care Fraud," June 15, 2007, http://www.nhcaa.org/eweb/dynamicPage.aspx?webcode=anti
_fraud_resource_centr&wpscode=TheProblemOfHCFraud.
(Due to its length, this URL may need to be copied/pasted into your
Internet browser's address field. Remove the extra space if one exists.)
About Sun Life Financial
Sun Life Financial is a leading international financial services
organization providing a diverse range of protection and wealth
accumulation products and services to individuals and corporate
customers. Chartered in 1865, Sun Life Financial and its partners today
have operations in key markets worldwide, including Canada, the United
States, the United Kingdom, Ireland, Hong Kong, the Philippines, Japan,
Indonesia, India, China and Bermuda. As of March 31, 2007, the Sun Life
Financial group of companies had total assets under management of US
$386.6 billion.
Sun Life Financial Inc. trades on the Toronto (TSX), New York (NYSE) and
Philippine (PSE) stock exchanges under ticker symbol SLF. Visit Sun Life
Financial’s website at www.sunlife-usa.com.
About The Sentinel GroupTM
The Sentinel Group, a division of Optimal Benefit Services, Inc., is a
recognized health insurance anti-fraud services leader, supported by
sophisticated, state-of-the-art technology and years of in-depth
intelligence gathered on claims from healthcare providers. To prevent
payment of erroneous, abusive or potentially fraudulent claims, The
Sentinel Group uses the best technology available, the IBM Fraud and
Abuse Management System (FAMS), in addition to various statistical tools
and networking leads, and combines this technology with a large,
experienced investigative and clinical staff.
Healthcare is a big business, and even by conservative estimates, the U.
S. healthcare system loses 3 to 10 percent of the $1.7 trillion dollars
spent on healthcare to fraud and abuse every year. The Sentinel Group
has been successfully fighting healthcare fraud and abuse for more than
17 years and is headquartered in Lake Forest, Illinois.
Group insurance policies are underwritten by Sun Life Assurance Company
of Canada (Wellesley Hills, MA) in all states, except New York. In New
York, group insurance policies are underwritten by Sun Life Insurance
and Annuity Company of New York (New York, NY). Group insurance policies
are underwritten by Genworth Life and Health Insurance Company (Windsor,
CT) in all states under Policy Form Numbers GP-A and GP-D (or
appropriate state edition with respect to Stop-Loss policies).
Genworth, Genworth Financial and the Genworth logo are registered
service marks of Genworth Financial, Inc., and are used subject to a
license agreement. As of June 1, 2007, Genworth Life and Health
Insurance Company is a subsidiary of Sun Life Financial Inc. and is no
longer affiliated with Genworth Financial, Inc. Product offerings may
not be available in all states.
©2007 Sun Life Assurance Company of Canada.
All rights reserved. Sun Life Financial and the globe symbol are
registered trademarks of Sun Life Assurance Company of Canada. Visit us
at www.sunlife-usa.com.
SLPC #17570
06/07 (exp. 06/09)
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