Health Care Provider Service Detail

As healthcare providers, you pride yourselves on offering high quality services and expect insurance plans or Medicare payments accurately reflect all your contracts' rates and terms or CMS guidelines and payment schedules. But all too often that isn't the case.

As financial experts, we pride ourselves on our ability to find those 'hard to identify' issues that don't accurately reflect your rates and terms, we ensure reimbursements are correct, and recover all dollars due you.

• Our experts will review your 'closed' claims (considered by your organization as reimbursed correctly and not being pursued internally)
• We will ensure reimbursements are in accordance with contractual terms and language and/or CMS guidelines and fee schedules for all product lines.
• Our programs will uncover errant reimbursements and we will validate that these potential recoveries are not being pursued by your organization.
• Upon completion of each Payers' audit review, we will present our findings.
• If agreed upon, we will lead the effort in recovering funds your organization contractually deserves.

You'll benefit from…

• Proven track record of identifying and recovering reimbursement errors.
• Extensive knowledge of CMS guidelines and its fee schedules that allow us to validate Medicare/Medicaid reimbursement methodology.
• Experience in applying and validating Provider contract rates, terms, and all footnote language to ensure correct claims reimbursement.
• Perfect mix of software applications will validate your organization's claims' reimbursement process.