Pre & Post-Payment Integrity
To Protect Healthcare Plans & Their Members
Saving Plans & Members 5-25% of Their Healthcare Spend
Of Healthcare Spend Saved
The Industry Average In Findings
Of Claims Reviewed
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 and/or Network protects plan assets against overbilling, fraud, waste, and abuse.
Frank Tecumseh, Vice President of Human Resources Firekeeper's Casino & Hotel
“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.”
Understand how to identify and defeat six types of over billing errors that are driving premiums up.
Payment Integrity That Works For You
Even if your plan has improperly paid claims, it’s not too late to identify overpayments and recover plan assets. Using the ClaimIntelligence™ platform to assist with recapturing assets, we respectfully and diligently collect, reconcile and deposit recouped funds. This process recovers 5%-15% of paid plan assets.