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
administrator accountable.”
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Vice President of Human Resources Firekeeper's Casino & Hotel
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American healthcare spending recently eclipsed $4T USD, spurred by improper payments and billing firms that are incentivized to maximize provider reimbursement at all costs.
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.”
President
Novo Benefits & Apta Health
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.
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ClaimInformatics filters out suspect claims and identifies overcharges before they are paid, by leveraging our proprietary
pre-screening technology.
“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”
“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!”
