Updated: Sep 16, 2019
Are you sure that you are receiving all reimbursement due to your physician organization according to the terms of your payer contracts? Many practices are confronted by constant payment errors, in many instances as much as 5% of submitted claims are not paid correctly.
Historically, insurance companies paid a percentage of charges, but in today’s system, payers set prices for each service. The challenge is to ensure that you actually get that price. Underpayments often go unnoticed but they affect your bottom line all the same. Spending a little time now to improve tracking and management of payments pays off down the line.
To reduce underpayments and denials, practices need tools that proactively addresses clinical documentation, coding, contracting, fee schedules, billing, and collections. By leveraging an integrated approach to the clinical and financial sides of the house, practices can more efficiently aggregate, assess, and apply valuable data from disparate systems.
CPRvista changes the way providers and practices think about monitoring payer reimbursement. We deliver our analytics dashboard and advisory services in return for a monthly subscription and our recovery services on a contingent fee basis. Unlike other payment review software tools that require clients to load their own contracts and fee schedules, perform analysis reports, and appeal findings with payers themselves, MCAG brings a total service solution to providers that frees up staff time so that it can be focused elsewhere.
We work with limited support from your staff to determine root cause analysis on issues identified and provide actionable recommendations to decrease future concerns. We continue to run this analysis on a monthly basis for you to capture all underpayments on an ongoing basis. This will help ensure that your organization is getting every dollar is has earned. We also work with our clients to help fix any identified compliance or quality issues in their billing systems.