Services
Performant Audit & Recovery is synonymous with the industry’s most powerful overpayments discovery and recoupment capabilities. We will identify your maximum recovery opportunity, and go the last mile to restore overpayments to your bottom line. Client fees are performance-based, and calculated as a percentage of results delivered.
Precision Audits
Realizing the full value of recovery requires a truly high-caliber audit process. Performant’s audit capability encompasses both COB and Claims Review, and includes:
- State-of-the-art data matching and skiptracing techniques to detect appropriate primary payers and claims eligibility.
- COB expertise in matching beneficiary coverage to government and group health plan coverage rules.
- Cross-platform data analysis and matching of beneficiary and spouse coverage information, carried through by a complex follow-up process.
- Customized edits to detect exact and near-duplicate claims, bundling, coding errors, mutually exclusive occurrences, claims processing errors, and non-covered expenses.
- Statistical analysis to detect outliers, and thus reveal bulk errors and abuse.
- Manual and complex audits. Our expert team includes audit specialists from Fortune 100 managed-care organizations, as well as licensed clinicians and other professionals. We leverage in-depth knowledge of claims processing, medical guidelines and regulations, payment rules for a variety of clients, medical documents, and processes.
More Effective Recovery
Performant’s skills in recovering overpayments are second to none. We drive results through:
- A proven, proprietary recovery platform. It includes best-in-class skiptracing tools, electronic document handling, event tracking, and scheduling and follow-up.
- Can we really deliver superior results? We have performed secondary audits of claims already reviewed by other companies to uncover up to 18% in additional client value.
- A flexible approach that either provides full-service recovery or complements offsets.
- 30 years of stellar recovery results for both government and commercial clients.
- Continuing investment in innovation, unmatched quality, and the industry’s top personnel.
Reports
In addition to strengthening your current bottom line, Performant Audit & Recovery reports can also help you identify ways to improve claims tracking and payment processes to minimize, if not eliminate, future overpayments.
Compliance
Performant’s procedures are fully compliant with H.I.P.A.A., F.D.C.P.A.,
and federal and state Do Not Call regulations. They are also aligned with
Government Privacy Requirements as defined in our current contracts with
C.M.S., the Department of the Treasury, the Department of Education, and
State Debt Clients. To learn more about how we can help your organization,
contact us at 1 866 253 6183.