UNDERPAYMENTS RECOVERY

Complex reimbursement structures and shifts towards value-based reimbursement models are changing the way hospitals are paid for services. Each year, it is estimated that hospitals are underpaid between 1-5% of Net Patient Revenue. These underpaid services translate to millions of dollars that could hit the bottom line of your healthcare system.

 

Our Solution

Our Solution

• Revint offers a customizable offering of underpayments recovery solutions

• We provide managed care and governmental payer focused zero-balance retrospective identification and recovery of underpaid and denied dollars services

• We offer prospective claims support and safety-net services

• Our help is a turn-key solution with limited resources required from clients

Our Advantage

• Clinical Appeals: Our highly trained clinical nurses perform comprehensive audits and medical record reviews in order to determine how to best argue and collect clinically disputed underpaid claims

 Contract Management: We ensure appropriate reimbursement calculations across multiple payors

 Charge Capture: Our CDM experts conduct targeted audits to identify missing or misbilled charges

 Proprietary Pricing Technology: Ability to tailor pricing for facility-specific reimbursement structures

Underpayments Recovery

Results

Typically identify 1-5% of Net Patient Revenue in underpayments. Deliver results for underpayments through a variety of analytical tools e.g., the defense audits on medical necessities, appropriate reimbursement per contract across payors, CDM analysis to capture misbilled charges, etc.
Underpayments Recovery

Experience

Over 20 years of offering underpayment and revenue integrity services across clients bringing the best of technology and team experience.

Underpayments Recovery

Value

Work with limited to no support from your staff to recover underpayments. We provide root cause analysis on all denials identified and recommendations to decrease future denial rates. Additionally, we ensure we communicate and help you fix any identified compliance or quality issues in your billing systems.

Discover More Solutions

Underpayments Recovery

Revenue Assurance

Suite

Assures the episode of care was coded, charged, and discharged accurately for optimized reimbursement

Payer Accountability

Suite

Ensures the claim was processed correctly and recovery was optimized for expected reimbursement

Medicare Reimbursement

Suite

Validates that your organization was appropriately reimbursed for the population you serve