Medical Insurance Underpayment Retrieval

Our team helps Hospitals/Medical Facilities to identify and retrieve medical underpayments from insurance carriers who fail to pay, per their contract. Our experience from serving over 500 medical facilities in the last year is that all medical facilities are challenged to recover underpayments due them by the insurance payers.

Our service retrieves these medical underpayments via a forensic audit that is performed once a remittance has been fully adjudicated and AFTER all other RCM efforts have been exhausted, including other internal or external underpayment recovery efforts and processes.

Executive Summary

Medical underpayments retrieval has been our singular expertise for over 10 years.We don’t integrate, replace, or have anything to do with the client’s current software. We have nothing to do with revenue cycle management or processes. We pay for the entire process and only bill the hospital if we are successful; there is no risk, we are completely contingency based. We take on 100% of the risk and effort to recover revenues for our clients. There is nothing on the market like what we offer.

Case Studies

• A hospital network: $30 million in underpayments from just three facilities
• A large Ohio physician group: $7 million in underpayments
• A Tennessee clinic: $1 to $1.5 million in underpayments per payer contract
• A Missouri hospital: Over $20 million in underpayments