Payment Integrity Audit – Underpayment Recovery
Recover your lost dollars through a retrospective review of paid claims
Facility and Physician Underpayment
Retrospective Claim Review
Coding and Billing Insights
Contractual Reimbursement Validations
Recoveries
$
0
M
Underpaid Claims
1-
0
%
Recovery Rates
0
%
Recovery Per Claim
$5-$
0
K
Underpaid Trend Scenarios
0
+
Zero Balance to Infinity
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Recover millions of dollars by converting your zero balance claims inventory into a source of additional revenue.
360° Review
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Incisive 3P (Patient-Provider-Payer) perspective, accurate contractual reimbursements, and facilitating billing/coding compliance.
Predictive Analytics
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State-of-the-art technology combining human investigative insights with machine learning and AI.
Data Marshall’s Payment Integrity Audit services generate “Wealth from Waste” for hospitals, physicians and physician groups. It is estimated that the providers are underpaid 1-3%. These underpayments result in the loss of millions of dollars which can hit the bottom line of your systems. We offer an investment free approach to recover unclaimed revenue from closed claim inventory. Our expertise lies in interpreting Medicare, Medicaid, Managed Care and Commercial health plans.
Differentiators
Payer Expertise
(Medicare, Medicaid, Managed Care and Commercials)
Physician
Underpayments
No Threshold on Underpayments Recovered
Contractual Reimbursement Validation
Billing Insights
Transfer DRG
How do you Benefit?
A 360 degree retrospective claim review from a Billing, Coding and Reimbursement perspective including inappropriate denials, missing follow-ups or non-payments, Contractual updates and Payment variances
Convert closed claims dump into a source of additional revenue directly improving your bottom-line
Our underpayment recoveries range from $1M (for small hospitals) to $15M (for large hospitals) in a period of 12-18 months
Concerted efforts on low dollar recoveries, ensuring that every deserved dollar is recovered
Comprehensive sweep through 2nd and 3rd Pass review