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Services
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For the self insured
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Why not to use your accounting firm |
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Accountants typically audit a representative sample of data, not every claim. They also are trained in reviewing the mathematical calculations in the sample, not medical claims data. Since these charges are taken from the summary bills, or the UB-92s, line item errors are undetectable an accountant audit. In this situation, the final document presented to the CFO would be based on inaccurate information.
Health Plan Navigator only reviews medical bills and charges. We are experts in determining appropriate charges, what the cost should be, and recovering overpayments for you. Hiring a firm that does not specialize in medical bill review and recovery does not serve your shareholders, your employees, or your bottom line.
We perform expert audits of both specific and aggregate claims using industry standard claim administration guidelines such as Trilogy and CMS Claims Manuals and American Medical Association CPT coding principles. Our evidence-based approach is supported by state-of-the-art proprietary clinical administrative processes created over the past 15 years by seasoned claims professionals, Registered Nurse auditors, multi-specialty medical consultants and professional software developers.
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