We identify under-payments on hospital and surgery center provider's “Zero" balance paid claims reports. We only look at claims six months old or older, recorded as “paid in full” by the hospital's billing department. Any unpaid revenue we identify or collect on behalf of the hospital will be monies administrators were unaware could still be collected. Our forensic auditing team will only be auditing, "ZERO" balance paid in full claims. We don't look at active claims still working their way through the billing process, or claims resulting from billing errors. We also don't involve ourselves with active claims by rebilling with different modifiers, nor do we audit denied or partially paid claims.

We provide our proprietary process which consistently identifies a substantial amount of provider revenue that's been underpaid by contracted commercial Payers. Uncollected profits that enter this black hole are rarely recovered because they don't show up anymore. If the hospital were to run an A/R report, these underpayments no-longer show up, and that's because they have been incorrectly recorded on the books as “paid”. We assume all your claims were billed correctly, and that payers paid the claims with no denial codes. That said, we find an abundant amount of revenue/profits on old claims that appear on the books to have no current value to hospitals. We don't go after patient responsibility and we never upset Payers. We have a “soft” appeals approach and methodology and it works very well for Payers. We have a system that works and don't deviate from our proven process.