Powerfully Precise & Logical Payment Accuracy
Healthcare payment integrity is the process of ensuring that the health claim is paid correctly by the responsible party for eligible members according to contractual terms. Payment integrity uses data mining and analytics to identify fraudulent, erroneous, or abusive claims, and supports resolution with improved workflows, and promotes ongoing payment efficiency. Healthcare payers have increasing challenges to ensure that every dollar spent is spent wisely. With limited time and resources, the companies will often need the assistance of a partner who can integrate with their existing practices and focus only on increasing operational performance and achieving significant medical and administrative cost reductions.
At AnnexMed, we provide Healthcare payment integrity services that have different solutions to deliver efficient, thorough, and accurate results. The solutions include COB (Coordination of Benefits) Services, Credit Balance Services, Subrogation Services, and Pharmacy Audit and Compliance Services. These solutions are tailored based on your organization’s needs, that provides flexible health plans to focus on the business. At AnnexMed, we understand the impact that recovery of inaccurate claim payments has on your medical spending.
Payment Integrity capabilities include:
- Payment Recovery
- Identification of Coding Errors
- Credit Balance Services
- COB discrepancy review
- Overpayment Identification
- Help in recovering payer inaccurate payments
- Improve process compliance by reducing frauds
- Ensure accurate and timely payments
- Avoid Member Abrasion
- Strengthen Provider Relationship
- Reduce total cost through technology enablement