Analytics - Revenue Recovery Opportunity

Many healthcare providers continue to write off millions of dollars in contractual adjustments that are a direct result of third-party underpayments even though some are confident their billing, contract management systems and payer reimbursement audit procedures are adequate.   Our executive board is made up of former hospital administrators who know that simply because systems are operating and processes are in place does not necessarily mean that the calculation of complex datasets, shifting managed care terms, rates and government reimbursement are accurate or complete in any organization.

Prevalent has helped hospitals recover millions of otherwise lost revenue. We have a powerful track record of recovering both commercial and Medicare Transfer DRG and IME underpayments for providers across the nation.  Prevalent utilizes its proprietary software to immediately and efficiently work through the identification and follow-up tasks required to validate the accuracy of commercial and Medicare/Medicaid billing, to ensure compliance and to make final determination of various underpayments.

Missed Revenue Opportunity Assessment
Correcting the various underpayment mistakes requires an in-depth analysis of all services according to the complex terms of today's health care contracts. Utilizing a balanced approach of proprietary analytics and experienced managed care auditors, Prevalent identifies missing money from inaccurately billed and inaccurately paid claims.  This retrospective review incorporates innovative discovery methods, team experience and established payer relationships. 

Prevalent delivers the ultimate contractual underpayment assessment by building your contract calculation models and importing your claims data.  This assures a quality assessment of existing payer audit systems and processes.  In addition to collecting the identified underpayments, Prevalent’s analytics reveals error issues and process improvement opportunities so you avoid future underpayment losses. 

Revenue Recovery Specialists
As a contingency-based review or full scale engagement, Prevalent's team is result oriented.  We stand by our system and out team and their unparalleled experience and capabilities in data analysis, patient account administration, managed care contracting, coding and government reimbursement.  

Retrospective Revenue Cycle Review 
Engaging Prevalent for a retrospective recovery review provides at the very least "peace of mind" that accurate payment for all services is taking place.  Prevalent can provides an ad hoc review of past claims for billing and coding inconsistencies.  As part of our process, Prevalent not only audits behind your process but also communicates identified trends so you can adjust your processes for even more timely and accurate internal audits.  This can have a significant impact on your cash flow within weeks, improve your balance sheet, P&L and ultimately the bottom line.

 

 

 

 

Prevalent, Inc. a subsidiary of Axcension, Inc.

For more information or to see a demo of our product please contact us today.

23537 Kingsland Blvd Suite 124, Katy, TX 77494    l    (832) 413-5990  contactus (@) prevalenthealth.com

 

 
 
   

 

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