Pre & Post-Payment Integrity
To protect Healthcare Plans
and their Members
Saving Plans & Members 5-25% of their Healthcare Spend
“Armed with the transparent results ClaimInformatics provided, we were able to see
how our TPA was actually performing. Now we
have the tools to hold our third-party
Vice President of Human Resources Firekeeper's Casino & Hotel
Health plans are facing a triple threat
American healthcare spending recently eclipsed $4T USD, spurred by improper payments and billing firms that are incentivized to maximize provider reimbursement at all costs.
Increasing Improper Payment Rates
According to the Centers for Medicare and Medicaid Services, improper payment rates have ballooned from 9% in 2018 to 21% in 2020. Some
officials admit that the real number may be closer to 27%.
Plan administrators and fiduciaries are ultimately responsible for ensuring compliance, and that their TPA or Network protects plan assets against overbilling, fraud, waste, and abuse.
“The ClaimInformatics team understands the ins-and-outs of medical billing better than any group with whom I have worked. Their technology uncovers fraud, waste, and abuse that other systems miss completely.”
Novo Benefits & Apta Health
That Works For You
Even if your plan has improperly paid claims, it’s not too late to identify overcharges and recover plan assets. Using the ClaimIntelligence™ platform to assist with recapturing assets, we respectfully and diligently collect, reconcile and deposit recouped funds.
We Stand by our Clients & They Stand by Us
“CI’s payment integrity program has helped MLBF identify an extraordinarily large amount of overspending and inefficiency we would otherwise not have found. I’d recommend CI to any funds looking to root out overpayments or inefficiency in health benefit costs”
— Lou Mandarini, Administrator
Massachusetts Laborers Benefit Fund
“As an ERISA attorney, CPA, and healthcare consultant, I’ve seen organizations claim to deliver payment and cost reduction. ClaimInformatics stands out because they actually delivered on their promises. We highly recommend ClaimInformatics!”