UNDERPAYMENT RECOVERY/MANAGED CARE AUDITING
CCBI’s managed care program is designed to assist providers in maximizing benefit payments from managed-care payers, regardless of reimbursement method. Regardless of your contract volume, CCBI will significantly enhance reimbursement through this program. Nationally, contract underpayments average between 4% and 8% of managed care receivables because payers have no incentive to pay correctly. We will analyze all account types, including both inpatient and outpatient and computes the expected payment for each account. Our experts will continually monitor managed-care payers and follow-up for prompt payment at the contract terms.
Getting started with our managed-care claims expediting service is easy. Providing copies of managed care contracts which are entered into our system along with your paid claims we will calculate the expected reimbursement.
Some underpayment reasons include:
· DRG paid is different from DRG billed
· Implantable not paid
· Incorrect contract rate used
· Payer has multiple contracts (HMO/PPO/POS) and access the incorrect rate
· OB additional days not paid
· C-Section delivery paid at Normal delivery rate
· Outpatient surgery with multiple procedures
· Endoscopic procedure paid at minor surgery or SDS
All benefits are paid directly to you. CCBI fees are calculated on a contingency basis and are invoiced to you. In summary, this service allows you to outsource all or part of your managed care accounts, confident that reimbursement on these accounts will be paid in accordance with contract terms, and collected in a timely manner.
Getting started with our managed-care claims expediting service is easy. Providing copies of managed care contracts which are entered into our system along with your paid claims we will calculate the expected reimbursement.
Some underpayment reasons include:
· DRG paid is different from DRG billed
· Implantable not paid
· Incorrect contract rate used
· Payer has multiple contracts (HMO/PPO/POS) and access the incorrect rate
· OB additional days not paid
· C-Section delivery paid at Normal delivery rate
· Outpatient surgery with multiple procedures
· Endoscopic procedure paid at minor surgery or SDS
All benefits are paid directly to you. CCBI fees are calculated on a contingency basis and are invoiced to you. In summary, this service allows you to outsource all or part of your managed care accounts, confident that reimbursement on these accounts will be paid in accordance with contract terms, and collected in a timely manner.