18 King Street East, Toronto, Canada

Medical Underpayments

Recovering Unpaid Claims for Healthcare Providers

Intro

In the complex landscape of medical billing and insurance reimbursements, healthcare providers often face the challenge of underpayments from commercial payers. These underpayments can have a significant impact on a provider’s revenue and financial stability. We explore a comprehensive solution for identifying and recovering underpayments in the USA, helping healthcare providers reclaim the revenue owed to them.

 

  1. The Underpayment System Analysis Audit

The Underpayment System Analysis Audit is a proprietary system specially designed to identify and recover underpayments for healthcare providers. This system not only uncovers underpayments but also efficiently manages denials, overpayment fines, appeals, and requests. Additionally, it serves as a contract modeler, enabling providers to negotiate more favorable contracts in the future.

 

  1. The Recovery Process

Healthcare providers often face uncertainties and risks when attempting to recover underpayments. However, with this specialized system, providers can rest assured that all costs and risks associated with the recovery process are covered. This includes contract load fees, appeals, audit, and training. The recovery fee is 100% contingent on a percentage of the successfully recovered underpayment fees from the initial audit of past claims.

 

  1. Speedy Analysis and Appeals

Time is of the essence in underpayment recovery. The Underpayment System Analysis Audit expedites the process, typically completing the analysis and starting the appeals process within 14 days after receiving all contracts and data files.

 

  1. The Underpayment System’s Success

The Underpayment System has a strong track record of success, consistently uncovering 5-30% of commercial payments that have been incorrectly paid on every analysis. When it comes to collection statistics, the system successfully identifies and recovers 85-90% of underpayments owed on identified claims from commercial payers.

 

  1. Time Sensitivity

Healthcare providers need to act promptly to recover underpayments. Most contracts allow providers to appeal claims that have been underpaid or paid incorrectly for up to 12 months from the last response by the insurer. After the 12-month mark, the opportunity to bill or collect on those claims expires, resulting in lost revenue for providers.

 

  1. Beyond Initial Claims

The Underpayment System goes above and beyond in recovery efforts. It can identify dollars that were underpaid even after the Electronic Medical Records (EMR) or Electronic Health Records (EHR) systems have processed claims as “PAID IN FULL.”

 

  1. Boosting Financial Stability

By leveraging the Underpayment System Analysis Audit, healthcare providers can significantly improve their financial stability. Recovering previously unpaid claims ensures that providers receive the full reimbursement they are entitled to, enhancing cash flow and overall revenue.

In conclusion, medical underpayments are a common challenge faced by healthcare providers. The Underpayment System Analysis Audit offers a robust and effective solution for identifying, managing, and recovering underpayments from commercial payers. With a high success rate and a speedy process, providers can boost their financial stability and secure the revenue they rightfully deserve.

The analysis and appeals process usually take around 14 days after receiving all contracts and data files.

Yes, the recovery fee is 100% contingent on a percentage of the successfully recovered underpayment fees, and all costs and risks are covered.

No, claims that have been underpaid or paid incorrectly for over 12 months from the last response by the insurer typically expire and cannot be billed or collected.

The system consistently uncovers 5-30% of commercial payments that have been incorrectly paid, with a high success rate in identifying and recovering underpayments.

Underpayment recovery enhances financial stability by ensuring providers receive the full reimbursement they are entitled to, improving cash flow and overall revenue.

Why Choose Us?

We offer expertise from diverse professionals, customized solutions, a contingency-based approach, and seamless implementation to maximize savings and benefits for your business.

With over 20 years of experience, our service specialists are well-versed in delivering effective cost reduction and savings solutions.

We understand that every business is unique, and our services are customized to fit your specific needs and requirements.

There is no need to change your current suppliers to benefit from our services.

Our goal is to help you uncover the highest possible savings and cost recovery opportunities for your business.

How It Works

Our process involves a quick meeting, a savings snapshot, benefit confirmation, and implementation to secure savings gains for your business.

The initial meeting is a quick, no-obligation session where we gather basic information about your company and determine which programs may benefit you.

Our proprietary software analysis systems identify potential savings and outline the projected benefits.

Once you're satisfied with the projected savings, our team performs a comprehensive assessment of your business data.

With all the necessary documents in place, our implementation experts work with your service providers and tax agencies to secure savings gains.

SERVICES

Contact Us

Ready to embark on a journey toward financial efficiency and growth? Use the "Contact Us" form to schedule your initial meeting. Our team will confirm the session and guide you through the process.
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