Medical Underpayment Reimbursements
The future of medicine COSTS MONEY.
And large Hospitals and Medical Groups, are not aware that they are leaving 20%-30% of their Total Revenues on the table.
We are the disruptors leading the charge in changing that once and for all.
And we have a:
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100% Success Rate
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average recovery of 22% of Total Carrier Revenues
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often initiating collections within 20 days of receiving relevant data
Our Services
We offer the MOST Advance Forensic Auditing Software in the Healthcare space, which we use to analyze every payment remittance received over the past 12-24 month period, to verify that they were paid in full according to the payer agreements. Then our team works with the payers to recover what is due to our clients. We have a 100% Success Rate, we consistently retrieve an average 17% over the industry standard Medical Underpayment reimbursement rate, and we offer ZERO RISK engagement.
Revenue Cycle Remedy
Our forensic audit is performed on remittances AFTER all other RCM efforts have been completed including other internal or external underpayment recovery efforts. We only engage remittance files that our clients expect no further revenues from. Therefore, our services compliment all other RCM efforts and provide NEW revenues…100% of the time.
100% Success Rate
Our results are unrivaled. To date we have analyzed billions of dollars in reimbursements and remittances against 1,000s of unique and often complex payer contracts and have found noncompliance and underpayments for 100% of our clients. The typical result is 10%-30% of gross payer receipts in recovery.
Risk Free Engagement
We work solely on a contingency basis. There are no upfront fees, costs, or ongoing tasks required from our clients. We take on 100% of the risk and effort to recover revenues for our clients. We are only compensated when we successfully recover your underpayments. And all data is processed using our Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliant, proprietary encryption platform. So you data is always safe.
Contract Savant
Our Contract Modeler is designed to "plug and play" proposed reimbursement scenarios, rates, and contract terms using historical claim utilization data to determine revenue outcomes based on a provider's specific case/service mix. This valuable tool allows the healthcare provider to assess the Payer's contract proposal's impact and identify opportunities to maximize revenue.
Forensic Analysis
Using two sources of your critical data, our Executive Team builds an algorithm specific to your organizations established contracts. The Contract Modeler software intelligence and our team of experts will then identify the variances in the payment reimbursements and the healthcare provider's contractual agreement with the Payer.
Recovering the funds
We then recoup the underpayments identified in our analysis with a suite of standard claim utilization reports and customizable, user-friendly strategies. As well, these reports are designed specifically to enhance the ease of tracking and evaluating current and future revenue operations.
Medical Underpayment Rectification Activated
Ready to find out more?
We have analyzed billions of dollars in reimbursements and remittances against 1,000's of unique and often complex commercial contracts and have found noncompliance and underpayments for 100% of our clients. The typical result is 10%-30% of collections from payers or 22% of Total Carrier Revenues..