Prevent Healthcare Insurance Coding Claims, Fraud, Waste and Abuse

SAVES HEALTH PLANS MONEY

• Reduce Claims Payment of Incorrect Billing
• Avoid Increasing Staffing Costs
• No Expensive Equipment to Purchase
• Avoid Costly Fraud and Abuse Training and Supervision Development
• Cost Effective Means of Outsourcing
• Decrease Stop Loss Premiums based on Claims Payment

FLAGS INCORRECT MEDICAL BILLS

• Federal, State, and Health Plan Specific Edits
• Pre-Payment Claims Editing
• Editing of Paid Claims
• Train Claim Processors to Detect Errors

PROVIDES EXTENSIVE ARRAY OF ONLINE REPORTS

• HIPAA compliant Secure Website
• OIG SIU Reports
• Management and Financial Reports
• History Reports
• Claim / Provider / Member Reporting