outsourcing servicesAUDIT & RECOVERY SERVICES

Claim auditing and overpayment recovery services for healthcare payer organizations

  • Analysis and recoveries performed by certified coding experts
  • Large claim audits
  • DRG Audits
  • Medical review department

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Stay on top of your plan’s progress & metrics with our benefit dashboard technology. Designed to connect Self-insured Groups, Consultants and Administrators like never before.

  • Up-to-date snapshots of benefit plan costs
  • Plan cost benchmarking to measure performance
  • Customizable alerts for various user roles
  • Track many metrics including eligibility, coding, turn around time, discount, budget

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Streamline your overpayment recovery and provider communication activity though technology

  • Technology platform designed to streamline overpayment and recovery efforts
  • Consolidated provider overpayment notifications via mail, fax and email
  • Payer refunds batched by provider across groups
  • Written/ Print provider notifications in all stages of recovery (requests, appeals, confirmations)

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Designed to evaluate self-funded employers’ benefit plans to ensure claim payment accuracy and plan compliance

  • Analyze up to 100% of all claims down to the code level
  • Verify payer compliance with service agreement, industry guidelines
  • Ensure performance guarantees are being met
  • Recover overpayments identified in audit

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