Our Payment Integrity services help you eliminate the pay and chase model and shift to the detection and identification of improper billing in prepayment environment. We provide this service on a contingency basis which eliminates the financial risk for our clients and help you pay for what is right. We combine the technology, analytics, and industry domain knowledge to identify improper payment trends as soon as they appear. Our experts’ partner with clients to provide a roadmap that adopts a hybrid method of claims and medical record review process. Our focus of profit discovery is improving our clients’ financial performance via a combination of audit, analytics, and advisory services.
Our Payment Integrity Suite Includes:
Situation: For a mid-size health system, Jade started with initial screening – random sampling audit using general payment integrity categories with the goal to understand the payment, coding and documentation issues missed out by the payer in the internal audits.