Managed Care Underpaid Claims Recovery

• Identifies and recoups funds from previously closed accounts
• Improves profit margins
• Ensures that all funds allowed under a specific contract are paid

Maintaining profitability in a managed care environment can be challenging. To help healthcare organizations improve their bottom line performance, CMRE provides comprehensive managed care compliance that maximizes reimbursements by reviewing paid-out claims and identifying payment errors. While other companies simply run files through a software filter, we prefer to apply our years of experience to identify potential claims recovery opportunities. Technology is applied where appropriate, but our clients will attest that our compliance auditors typically find items that software systems miss. Plus, as problem areas are identified, we inform the appropriate personnel, so corrections can be made to future accounts.

Highlights include:

• All work is handled by senior staff with more than 50 combined years of front-line experience
• Services are provided with little to no disruption of in-house staff
• Reimbursement is taken from recovered funds -- payment errors are identified without creating new charges
• Compliance audit results support continuous improvement initiatives
• Free test audit determines potential recovery opportunities