services for smart revenue resq consulting
Claims Review & Recovery
Ensured Compliance With Plans
Claims Review & Recovery
WE REVIEW AND RECOVER CLAIMS DENIED OR PAID INCORRECTLY
Contingency Based
Ensured Compliance With Plans
Claims Review & Recovery
WE ARE A PROVEN, CONTINGENCY BASED, PROVIDER FOCUSED, MEDICAL CLAIM AUDITOR
Ensured Compliance With Plans
Ensured Compliance With Plans
Ensured Compliance With Plans
WE PROMOTE EQUITY AND FAIRNESS IN CLAIM PAYMENT AND ENSURE COMPLIANCE WITH PLAN BENEFITS
Proven Software Algorithms
Evaluation & Testing of Provider/Benefit Configurations
Proven Software Algorithms
WE HAVE PROVEN SOFTWARE ALGORITHMS
Cost Savings Found
Evaluation & Testing of Provider/Benefit Configurations
Proven Software Algorithms
WE IDENTIFY COST SAVINGS OPPORTUNITIES
Evaluation & Testing of Provider/Benefit Configurations
Evaluation & Testing of Provider/Benefit Configurations
Evaluation & Testing of Provider/Benefit Configurations
WE EVALUATE AND TEST PROVIDER/BENEFIT CONFIGURATIONS
the general process
Key revenue items include
- INCORRECT PLAN BENEFITS ADMINISTERED
- SERVICES BUNDLED OR UNBUNDLED INCORRECTLY
- NCCI EDITS NOT APPLIED PROPERLY
- INCORRECT FEE SCHEDULE RATE PAID
- INADEQUATE FUNDING FROM CMS AND/OR STATE MEDICAID AGENCIES
- PROVIDER CONTRACT TERMS NOT PAID CORRECTLY
