Insurance Companies
Whether your organization is:- A health insurance company.
- A re-insurance company.
- A “P and C” insurance company. (Especially Automobile)
- An insurance company insuring foreign nationals in the USA.
- Workmen's Compensation.
Even if you are getting a discount applied to total bill charges, the discount is being applied to non billable and erroneous charges. Sometimes the facility will offer you a much more robust discount rather than deal with the depth of our audit. Either way you are going to lower your cost of claims experience. And of course when it comes to “OUT OF NETWORK” bills, the savings you will experience can be enormous.
When was the last time a hospital allowed you enough time to perform a detailed hospital bill audit prior to reimbursement?
- Medical Providers have forced the Insurance Industry to implement impossible restrictions on Insurance Carriers to pay claims.
- More than ever, hospitals are convinced their billings can make it through General Editing Systems and they will get full-payment for non-billable services hidden in the detailed billing statements.
- Currently Insurance Companies rely upon their editing systems to identify red flags on UB-04 Summary Statements without ever seeing the real items and services billed.
Our Program allows Insurance Carriers to pay claims within the time restrictions while reducing the facility charges to a true and accurate billing and a fair and reasonable price for services whether or not a participating agreement is in place.
Utilizing specially trained auditors, we do a unique manual “line by line” compliance audit before the claim is paid that will identify the hospital's erroneous charges.
We present the identified charges in an “Explanation Of Audit” (EOA) format to the hospital on irrefutable copyrighted denial reasons and request the hospital to send you a corrected bill or documentation why the items/services are billable (which they cannot).
We carry the process through to completion whereby payment of the adjusted bill is accepted by the hospital as full and final settlement with no balance billing to your organization or your insured!
Click Here to contact TrueFACS' corporate headquarters for additional information.
