We specialize in Payment Review and Recovery. We audit HMO, PPO, Managed Medicare, Managed Medicaid, Workers' Compensation, and any other health plan governed by a contract or fee schedule, in order to ensure that our clients receive full reimbursement. These reviews have recovered millions of dollars annually for our clients.

We accomplish this by using a three phase process that is designed to find money traditionally left on the table. Using a broad base of business  experts, we implement a collaborative effort based upon unique areas of expertise. Many in the industry seek to provide a one size fits all model which often results in many aspects of revenue management being marginalized.

The first step is to provide expertise on the eligibility front. By leveraging our eligibility expertise you will be able to add dollars in the following areas:

• Medicaid


• Medicare


• Security Supplemental Income (SSI)


• Children’s Services


• Victim’s Compensation Funds


• County medical service programs


• Specialty programs for breast, prostate or cervical cancer treatment.

Next we identify underpayments through a thorough review process that analyzes your internal data and compares receivables with contract or statutory fee schedules.

By identifying the errors that contribute to underpayments we are able to provide a feedback mechanism to your organization to better educate your staff of internal issues and remediation.

Lastly, we can provide invaluable services in pursuing monies owed to your facility. With co-pays and deductibles continuing to rise, receiveables departments are going to face an increasing challenge in maximizing this revenue stream. Our expertise does just that.

No financial investment is required, and our fee is based on dollars identified and received for your hospital.  It is not uncommon for hospitals to recover millions of dollars annually, and many of our clients later tell us that the money we found was money that they didn't even know existed!

We also can provide you with a FREE educational workshop to assist your organization in improving both patient financial qualification, with particular emphasis on medicaid and effective debt collection techniques as described below.