What’s your hospital’s overpayment liability?

Underpayment reviews may not amount more than the total overpayments owed, but it can reduce the bill. Every dollar counts as healthcare dollars are being heavily scrutinized by the payer. Why should providers not do the same? Revenue leakage needs to be plugged at every level, and there are numerous underpayments that can be identified.

How much is your hospital losing in underpayments?

The Office of the Inspector General (OIG) regularly conducts investigations regarding payments by law. In turn, there is some slight assurance that CMS operates in good faith and to their best effort. However, mistakes do occur.

,

What We Can Learn From the Titanic

When it comes to dependent eligibility verification, most employer-sponsored health plans think of it merely as a cost containment tool. While it certainly delivers cost containment, quite effectively we might add, it is important not to overlook the risk mitigation benefits of a dependent eligibility audit.

,

The Audit Front Line – The Call Center

As part of our standard audit process, Consova establishes a dedicated, toll-free phone number for employees to contact our call center team. During the audit period, call center representatives are available to answer questions concerning the process.

Experienced call center staff makes all the difference.

Green (Paper-Free) Audits

Beyond the audit approach, success in dependent eligibility verification comes down to three things—communication, communication, and communication. Crafting and distributing customized, data-driven employee communications improves audit compliance and creates a more employee-friendly audit experience.

Mitigating the Risks of Open Enrollement

With a large volume of new, unverified dependents being added to plans during open enrollment, an inclusive mechanism for eligibility verification will be central to a plan’s ability to contain costs and mitigate risk.