Why talk to Us
Much of the information we receive is from hardworking individuals
with integrity that have worked or are currently working
for a managed care company, insurance company, claim auditing
company, repricing vendor and/or discount broker.
We realize many times claims are improperly underpaid and/or
erroneously discounted due to honest mistakes; but by the
same token we also have identified countless well orchestrated
schemes designed to cheat providers out of their rightful
payments.
Relevant Facts:
- $1.9 trillion was spent on healthcare in 2004
- Current forecasts expect healthcare spending in the U.S.
to exceed $4 trillion by 2015.
- Provider claims are improperly underpaid and/or erroneously
discounted by tens of billions each year.
- Healthcare costs have continued to escalate in response
to decreases in provider reimbursement.
- Insurance premiums have increase dramatically in response
to increases in healthcare costs.
- Employee and insured’s out of pocket expenses have
greatly increased – as have deductions coming out of
employees paychecks for insurance costs.
The underpayment of claims (due to silent PPO’s, erroneous
bundling, noncompliant discounting, shortpayments, etc.)
does not just have a negative affect medical providers – it
costs us all.
|
.gif)
