Underpayment Recovery
(Underpayments Forensic Audit Systems)
KEY BENEFITS:
Proprietary software and a team of payer contract experts perform a forensic analysis of every remittance received in a 12-to-24-month period to determine contractual compliance of each reimbursement. We work with the payers to recover underpayments that are due to our clients.
- Creates a new profit center for hospitals and surgical centers
- Zero Risk. Works on a contingency basis. No cost for the process and only billed on recovery
- Custom software that hyper-focuses on contractualnoncompliance
- Doesn’t integrate with or replace current software
- Works with internal and external processes currently in place
- Work alongside Epic, PMMC or Cloudmed
We work with hospitals and medical groups.
With a 100% success rate, our results are unrivaled, and we typically recover 10%-20% of collections from payers.
Actual Underpayments Found:
A large Ohio physician group: $7 million in underpayments
in BCBS professional alone.
A Tennessee clinic: $1 to $1.5 million in underpayments per
payer contract
Small Texas Community Hospital: $4,048,555.44 in underpayments from BCBS alone.
A Missouri hospital: Over $20 million in underpayments
123-bed Texas hospital: $6 million in underpayments
through BCBS alone.
142-bed Louisiana hospital: $10 million+ in underpayments
for top 4 payors.
Large Pennsylvania Private Hospital: $1.2 million in underpayments from their 4th largest payer. Represents 18% of their collections for the payer.
A hospital network: $30 million in underpayments from just
three facilities.
