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Fair Isaac Announces Payment Optimizer 2.5, Bolstering Fraud Detection and Payment Integrity for Pharmacy Claims; Enhanced Fraud Detection Solution Adds Pharmacy Claims Analyses

Business Wire, August 17, 2005

MINNEAPOLIS -- Fair Isaac Corporation (NYSE:FIC), a leading provider of analytics and decision technology, today announced the release and immediate availability of Payment Optimizer(R) 2.5 solution, an enhanced version of its fraud detection system for healthcare payers that provides prepayment and postpayment analysis to dramatically reduce fraud losses and ensure payment integrity.

Version 2.5 adds pharmacy data and analyses to help detect suspicious activity and billing and policy errors in pharmacy claims at the point of sale, prior to payment or immediately after payment. This new feature will assist healthcare payers in managing steadily escalating costs and the anticipated surge in utilization when Medicare Part D of the Medicare Modernization Act becomes effective January 1, 2006. Part D will make voluntary prescription drug benefit available for the first time to more than 40 million Medicare beneficiaries.

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"Part D creates complex new challenges for payers, pharmacies and patients, which will require the use of sophisticated analytics to analyze the voluminous amount of data from the multifaceted healthcare delivery and payment system," said Dr. Andrea Allmon, director of healthcare operations and product management of Healthcare Solutions at Fair Isaac. "With the addition of pharmacy analyses to Fair Isaac's Payment Optimizer solution, payers can assess fraud risk in both pharmacy and medical claims, and obtain a comprehensive picture utilizing both claims sources to find even more fraud, abuse and errors."

By analyzing millions of interactions in a fraction of a second, using both incoming and historical data, Payment Optimizer 2.5 creates a multidimensional picture of the healthcare and pharmacy delivery system. Users can quickly identify fraudulent activity, including fraud types that previously could not be detected. Fair Isaac's proprietary advanced analytics enable accurate and efficient detection of new and unknown fraud patterns as well as subtle and complex trends by looking at each claim in relation to deep contextual information, such as the patient's and provider's histories. The Payment Optimizer solution is as powerful in containing costs as it is in identifying sophisticated emerging fraud and abuse schemes.

"Payers need to be better prepared for the growth of claims anticipated by the aging of the population, with a concomitant increase in per capita use of prescription drugs, and the additional claims to be driven by the advent of Part D on January 1," said Joanne Galimi, director of research at Gartner, Inc. "These new prospective technologies and approaches will not only detect fraud and abuse, but will assist in the prevention of lost funds."

The National Healthcare Anti-Fraud Association estimates that up to 10 percent of every dollar spent on healthcare is lost to fraud, abuse and error, draining the system of $170 billion a year. Preventing these losses could reduce consumer costs, reward shareholders and lead to improved treatments. To date, Payment Optimizer users have achieved a return on investment (ROI) ranging from 3:1 to 10:1, and have seen average savings of $25 to $30 for each claim reviewed, while taking 30 seconds to three minutes to review a claim.

About Fair Isaac Healthcare Solutions

Fair Isaac delivers proven products and services that unlock value and improve decision making for healthcare payers and providers, to the ultimate benefit of business efficiency, profitability and quality of care. Its healthcare suite is based on patented predictive modeling and profiling technologies that transformed the financial services industry, helping lenders reduce fraud losses by as much as 50 percent. Fair Isaac's advanced analytics help healthcare payers to identify fraudulent, abusive and erroneous claims before and immediately after payment is issued, without slowing claims processing or violating prompt-pay legislation. The fraud application is integrated with Fair Isaac Blaze Advisor, the leading rules management technology, for quick implementation and efficient claims management, including review and investigation. Through its approach to enterprise decision management, Fair Isaac empowers organizations to implement best business practices, including refinement of marketing strategies and improving clinical care. The suite also includes collections and recovery solutions, enabling hospitals and insurers to maximize recovery efforts. For further information, please go to www.fairisaac.com/healthcare.

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 over 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, visit www.fairisaac.com.

Business Services Industry

Fair Isaac Announces Payment Optimizer 2.5, Bolstering Fraud Detection and Payment Integrity for Pharmacy Claims; Enhanced Fraud Detection Solution Adds Pharmacy Claims Analyses

Business Wire, August 17, 2005

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