The Challenge/The problem
Hospitals and Medical providers often experience insurance payment delays and / or denials from third party insurance payers causing the provider to file endless insurance appeals and make numerous attempts to contact the patient for additional information. Unfortunately many of these cases end up placed with a third party debt collection agency or are deemed non-collectable by the provider and written off.
In a given year, up to 35 percent of the dollars a hospital is owed don’t reach the provider because a claim is denied by an insurance company, and 15 percent of those claims are never resubmitted!
It has been consistently proven that there is between 5%-30% of health care provider organizations annual revenue left behind as underpaid claims.
Unpaid Medical Claims leads to Millions of Dollars annually in lost revenues.
Providers need a reliable, cost-effective and quick partner to overturn denials, recover revenue and institute improvements so that these issues become a thing of the past. Developing Denials Management and Zero Balance Recovery is a natural evolution of (our Company name) mission to help the nation’s providers achieve a strong bottom line that supports advancing patient care.
Denied Claims / Zero Balance Resolution Management — Rework and research of under-paid and denied claims is quite costly and time consuming. It also drags down the performance of staff and cash flow working to maximize new claims and patient recovery.
We utilizes proprietary claims dispute analysis / Forensic software developed by health care and IT Experts as well as an experienced team of professionals who possess an in depth knowledge of the governing health care payment statutes and regulations for all insurance types!
Zero Balance Recovery identifies errors in charge capture, in claims processing and in adjudication in cases where less revenue was collected than expected. These situations are usually the result of incorrect adjustments or in cases where a claim was completely written off. Our team of experts work quickly to implement a plan so that a strong ROI is quickly achieved from your closed accounts!
Our Collection Process for these zero Balance Account is based on:
Adjudicating disputes with third party payers to bring timely resolution
Recovery success with all third party payer sources
Utilization of proprietary techniques and case load to achieve high levels of success
Assurance that payers abide by rules and policies governed by the insurance industry as well as local, state and federal government
What we need and what we will do
Provide us your Closed Zero Balance Accounts – we will do the rest!
Our Closed-Accounts Collection Service will perform a full retrospective review of the claims from a Billing, Coding & Reimbursement perspective in an effort to collect every dollar then identified as an under payment!
Getting you Started Making $$$ from Lost revenues
Under payment Audit and Re-Billing program is a No-Cost way to find lost revenues.Our specialized team review individual claim transactions, contracts, codes as well as apply algorithms to reprocess already closed (zero balance) claims that could have paid more!
Talk to Our “Zero Balance” Collection Specialist about an Underpayment Recovery Audit. Fully Contingency Based and there is no Upfront Cost!
We will share the revenues with you at no upfront Cost to you!