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Underpayment Claims Recovery Program

Meridian HSN Underpayment Claims Program specializes specifically on the 6-months old and older, zero balance accounts that are filed as “PAID IN FULL’. Our teams of forensic auditors use a proprietary process to identify underpaid claims from all insurance companies you are contracted with.

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Meridian’s Analytics team will perform the audit at no cost to you! Minimum facility time – 30 minutes or less to upload 835-electronic billing records through our proprietary encryption platform using the highest HIPAA standards. Our full audit takes only 72 hours. Our forensic process will identify all underpaid claims enabling our team to appeal and collect every dollar owed by insurers. Our program includes expedited payment options.

The majority of contracts allow providers to appeal claims that have been underpaid or paid incorrectly for up to 12 months from the last response by the insurer. After 12 months, they will expire in which you can never collect those underpayments

  • Retrospective Analysis of Claim Payments
    Review your current and past claims and provide you with a comprehensive breakdown of denials and underpayments.
  • Contract Consulting
    Our experts have over 27years experience in all aspects of Healthcare Contracting and have worked for both  insurance companies and providers.
  • Contract Modeler
    A tool to adjust your current contract and determine what would have been paid under the new reimbursement rates.
  • Claims Recovery Service
    There is NO CHARGE for our claims recovery service. Meridian HSN is making a difference unlike most analytic recovery. We only make money when the insurers pay the underpaid claims we appeal. Our plan backs up current plans at no cost.
  • Meridian uncovers an average of 12% to 30% of Zero Balance underpayments on every audit. 

Contact Meridian HSN for your complimentary underpayment analysis.

 

Underpayment Claims Recovery Program FAQ

Meridian’s state-of-the-art program identifies and recovers underpayments, manages denials, automates appeals and requests including negotiating more favorable contracts.

Medical practices in the United States are losing over $125 billion dollars every year due to underpaid and improperly denied insurance claims.

Q: What do you need from us to begin the auditing process?
A: We will need the following: a copy of your contracts from the Top 5 Insurers along with any addendums and fee schedules and at least one year but preferably two years or more of the 835 and 837 data files.

Q: How long does it take to complete your audit process?
A: Once we have received all contracts and data files we complete the audit within 72 hours.

Q: How long should we expect to wait to get paid?
A: Instead of making you wait for our team to file the appeals and go through the process of collecting on the underpayments we will pay you a respectable percentage of the total amount we identify as collectible in 14 days or less from when we complete the audit.

Q: How do you determine how much we will get paid? Recent Results?
A: Every situation is different however; our program delivers industry leading results, added value analytic and support data and in most cases doubles the industry standard in payments.

Recent Sample Audit Results:

  • 123 Bed Hospital – Identified 6 million in underpayments through 5 Insurance Providers
  • 142 Bed Hospital – Identified 10 million in underpayments
  • 5 Hospital network 500+ Beds – Identified 50 million in underpayments

Q: Do you threaten the insurance companies with a lawsuit like other companies that have contacted us?
A: NO. Quite the opposite actually. When appealing the specific claims, we approach the insurers in a manner of letting them know that they must have accidentally made a mistake and paid less than they owe according to the contract. Our detailed approach to the claim appeal and contract outlines the underpayments as well as penalties and interest charges which could be filed. Meridian sets the industry gold standard of conducting business with insurance companies by not filing penalties and interest resulting in very few disputed payment appeals.


Meridian Health Services Network – 1-800-994-1143