About Us
Medical Revenue Optimization
Payment Shortfalls
Welcome to Medical Revenue Optimization Payment shortfalls Recovery! We have developed the most advanced forensic audit system in the healthcare industry. Our proprietary software and team of payer contract experts perform a forensic analysis of every remittance received in a 12-to-24-month period to determine contractual compliance of each reimbursement. We work with the payers to recover Payment shortfalls that are due to our clients. With a 100% success rate, our results are unrivaled, and we typically recover 10%-20% of collections from payers.
Our team of contract specialists reviews each payer contract in detail and loads the contract payment rates and specific terms into our software system. We also work with the healthcare provider’s billing department and claim clearinghouse to electronically upload their files using our HIPAA compliant, proprietary encryption platform. Our software development team writes custom algorithms specific to the client’s contract rates and terms to perform the forensic analysis. We identify and review variances in the actual reimbursement versus the payer’s contractual obligation.
We have analyzed billions of dollars in reimbursements and remittances against thousands of unique and often complex commercial contracts and have found noncompliance and Payment shortfalls for 100% of our clients. Our team of experts will work closely with your staff to strategize and devise a plan to proceed with recovering revenue lost due to underpaid, suspended, and incorrectly denied claims.
Our expertise is performance-based, and we operate on a performance-only basis in that we are paid a fraction of what our clients actually receive in Payment shortfalls recovery. We are undiluted with other pursuits, and our results are demonstrably superior to others who offer similar services as an ancillary.
Contact us to learn more about how we can help your healthcare organization recover lost revenue from underpaid claims.
