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Healthcare Payer Services

Healthcare Recoveries

Today more than ever, your company must ensure that every claim is paid properly and by the right party. We're uniquely positioned to help our customers along the path from healthcare recoveries to avoidance. Our healthcare payment recovery services help Payers to:

  • Avoid incorrectly paid claims
  • Recover claims dollars
  • Provide auditing solutions on their behalf

Through our data mining and business rules engines, we can identify, track and even litigate on your behalf to ensure your exposure is accurate.

Utilization and Disease Management

We employ a URAC-accredited care management approach that combines clinical expertise and technology tools for utilization and disease management. This approach provides comprehensive, customized large-scale modeling, profiling, health risk prediction and data-driven management solutions. And it delivers solutions that:

  • Improve healthcare delivery and quality
  • Promote medical best practices
  • Reduce costs

And, since we're a designated Quality Improvement Organization (QIO)-like entity, we provide utilization and disease management reviews.


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Major Health Insurer

Intelligent claims processing reduces end-to-end cycle time by 75% and annual costs by 50%.

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Insights in Healthcare Recovery Services

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