Emdeon Audit & Recovery Services
Emdeon Audit & Recovery Services enables you to ensure that reimbursements received from payers meet negotiated, contracted reimbursement rates. With Government Managed Care and Commercial payer underpayments accounting for a loss of three to five percent of net managed care revenues, Emdeon Audit & Recovery Services, part of the Emdeon Payment Integrity Services suite, offers comprehensive accounts receivable evaluation, analysis and collection of undetected underpayments. In addition to addressing underpayments, contractual denials and zero-balanced third-party accounts, chronic problem payers as well as how to prevent systemic underpayment issues are also identified. The end result is collecting and preventing underpayments to receive an accurate reimbursement from payers virtually every time.
With Emdeon Audit & Recovery Services, an initial interview with management and staff is conducted evaluating process, procedures, contract structure and level of payer penetration. From there, a thorough and complete reconciliation of billing and payment information is performed. The reconciled patient account information is then compared to an expected payment generated from our proprietary contract management system. When complete, a detailed report is provided outlining the variance of reimbursements received to your negotiated, contracted reimbursement rates as well as the percentage of your accounts with potential variances for specific payers. Moving beyond the audit to the recovery process, payment variances are calculated and investigated to eliminate any false claims due to patient responsibility and cross registrations. True payer underpayments are then documented and presented to payers with Emdeon continuing to follow-up until resolution.
Interested in identifying and collecting contractual underpayments? Let our revenue cycle experts review your business and apply our expertise to your bottom line.
Contact UsFeatures
- Accounts Receivable Evaluation, Analysis and Collection
- Professional Payment Integrity Services Team with Extensive Experience in Both Payer Contracting and Patient Accounts
- Proprietary Contract Management System
- Results-Driven Service That is Unique to Each Client
Benefits
- Demonstrate Recovery of More than Just Easy-to-Find Debt
- Receive Customized Reporting
- Identify Problems to Prevent Future Loss
- Fee Contingency-Based on Net Recovery Amount
