Close the gap between peak cash potential and actual cash generated on claims by mitigating insurance denials and underpayments. Our platform is an intelligent workflow and analytics solution that helps ensure healthcare providers can get ahead of denial management and achieve the highest reimbursement from all insurance payers. Our client partners are able to accelerate cash from insurance payers by quickly collecting on claims that might otherwise be denied.
Identify and correct missed charges, denials, underpayments and untimely write-offs.
Ensure claims are paid right in the least amount of time.
Enhance productivity measures for staff and outsourcing services.
Our unique and powerful combination of data, analytics and workflow enables our client partners to accelerate cash collections faster than the competition while gaining greater insight into their A/R.
The majority of denials are recoverable and preventable — a typical hospital can recover between $5 to $10 million by addressing the issue.1
Our cutting-edge, proprietary technology combined with people domain expertise powers our outsourcing denial management solution to deliver both root-cause and actionable insights. Without adding a single staff resource, we’ll help you address legacy, aged, small balance, underpayments, zero balance and workers comp accounts, resulting in:
We accurately identify reimbursement and variances resulting from underpayments and denials for each claim — including primary, secondary, interim and repeat visits.
We provide detailed, accurate and actionable denial and underpayment analytics, as well as payer score cards that monitor performance by tracking response times and types, and percentage of allowable paid by insurance vs. patient responsibility.
Lower Cost to Collect
We leverage sophisticated workflow and analytics that allow us to work accounts in groups by root causes with proven resolutions — two to three times faster than competing solutions.
With our denial management technology, you’re able to reduce and prevent denials and underpayments — and maximize reimbursement from insurance payers.
The majority of denials are recoverable and preventable — a typical hospital can recover between $5 to $10 million by addressing the issue up front.1
Eliminate the “exception gap” that limits peak cash potential with our accounts receivable recovery and denial management solution.
To maximize reimbursement from insurance payers in the shortest time and at the lowest cost to collect, we work with you to enable your hospital staff to improve A/R collections using our comprehensive platform consisting of easy-to-use, powerful modules:
With our denial management technology and the combined features of dashboards and drill-down analytic reports, you’re able to reduce and prevent denials and underpayments — and maximize reimbursement from insurance payers.
Serving more than 500,000+ physicians and other providers in the U.S.
$5.2 billion in cash recovered to date for our provider partners
Serving more than 1,800+ hospitals and health systems
1Health Business Insights
Maximizing Medicare Reimbursement: Understanding the Three Types of Medicare Bad Debt
Discovering Missed Health Insurance Coverage: The 3 Most Common Types
Validating Comprehensive Insurance Discovery Against New, Internal Processes and External Vendors
How Hospitals Can Avoid Permanently Missed Reimbursement