An analytics and sequenced process-driven claims adjustment solution for payers and TPAs that want to identify billing outliers, change provider behavior, and reduce overpayments of low-dollar, high-volume claims.
What’s Included in Coding Advisor
Analytics-driven claims adjustment
- Software identifies billing outliers
- Reduces overpayments
- Increases claims accuracy
Help managehealthcare costs with pre-submission claims adjustment
Providing Measurable Value
outlier providers exhibiting better accuracy
average decrease in overbillings
PMPY medical cost savings achievable
Resources and Brochures
Help Increase Savings and Provider Engagement
Tackling improper payments on low-dollar, high-volume claims is often a daunting task for payers. It requires significant resources, access to sophisticated data, and high levels of expertise. Even then, the return can be marginal and disruptive to provider relationships. Historically, the cost of pursuing this type of overpayment has been cost-prohibitive. Coding Advisor changes that.
- Audit & Recovery Discover our overpayment audit and recovery services for payers that want to maximize recovery, reduce improper payment waste, and promote provider satisfaction. Learn more
- Pre-Payment Insight & Review Learn how our prepayment medical record and claims review solution helps identify improper payments before they are paid and reduce waste in the payment process. Learn more
- Integrated Repricing Network Learn how our claims repricing solution accesses more than 50 national & regional PPO networks through a single interface and uses routing optimization for maximum savings. Learn more
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