So Far Left, it’s Right: The Power of Identifying Potential Overpayments Earlier in the Process

When it comes to payment integrity, there’s obvious value in identifying potential overpayments as early as possible, which lets you move further left in the process.

Now we’re giving payers even more ways to see around the corner for greater efficiency and accuracy in claims billing and adjudication.

Eligibility Integrity

Identify other health insurance (OHI) coverage before a claim is ever submitted or before claim adjudication – shifting savings from “pay-and-chase” recovery to cost avoidance.

Utilization Management

Unify clinical authorization data and claims auditing from risk identification to pre-visit intelligence to point-of-care decision support — to prevent errors upfront and decrease post-pay audits by over 30%.

Payment Integrity

Ensure the medical record supports the care that was billed to the payer with physician-approved pre-pay services, plus retrospective audit and recovery services that deliver a 95% appeal upheld rate.

Overflow Medical Record Review

Don’t wait until you’re overwhelmed; get on-demand access to our team of 200+ board-certified physicians, registered nurses, and certified clinical coders committed to delivering accurate, compliant reviews.

Learn how moving even further left can be the right move for your organization.