360° Approach
Data Marshall’s approach encompasses the role of stakeholders within the entire claims payment process (Patient, Provider, Payer) and their corresponding impact on accurate claim reimbursements. Our exposure and experience across the entire claim life cycle allows us to drive compliance and to utilize highly effective revenue analytics to achieve revenue enhancements.
Provider
Revenue Enhancement ServicesPre-bill Audits
Predictive Denial Management
Pre-visit & Retro Authorization
Member Benefits & Insurance Verification
2nd Pass review & Low $ recoveries
Coding Audit and ComplianceProvider
Coding Audits – Prebill & retrospective audits
Clinical Documentation improvement
Provider Education
Healthcare Revenue AnalyticsPayment Integrity Audits
Underpayment Recovery
Credit Balance Resolution (Contractual / Overpayment validation)
Practice Audits & Consulting
Patient
Healthcare Revenue AnalyticsCoordination of BenefitsRevenue Enhancement ServicesPre-visit Patient Eligibility Verification
Collection of Patient responsibility upfront
Coding Audit and ComplianceMember / Dependent Eligibility Audit
Payer
Coding Audit and ComplianceBill Review Audit
DRG Compliance Audit
Medicare Risk Adjustment (MRA) Audits
Healthcare Revenue AnalyticsPost-payment audit
Appeals & Grievances
Fraud, Waste & Abuse
Revenue Enhancement ServicesClaims Adjudication – Business rules validation
Provider Contracting Services
Fee Negotiation Services