Let’s partner your way to ensure payment accuracy and improve payment integrity

We help payers and providers reduce costs, improve payment operations and processes, maximize performance and accelerate revenue recognition.

Our payment services combine auditing capabilities & expertise, payment business services, workflow digitization, and predictive & prescriptive analytics that deliver a complete cost optimization solution.

What we do

Payment integrity services

Medical-and-Pharmacy-Claims-Auditing

Medical and Pharmacy Claims Auditing: Mitigate overpayments, maximize savings, and reduce fraud, waste, and abuse

Data-Mining

Data Mining: Uncover savings through analytic data modeling

Subrogation

Subrogation: Software and services for third-party liability case management, from identification to recovery

Integrated revenue management solutions

Workflow-Design

Workflow Design: An assessment of your RCM workflow

Optimal-Analytics

Optimal Analytics: Identifying strategies and levers improve overall workflow performance

Payment-Posting

Payment Posting: Expediting payment posts and turn-around times

Denials-Management

Denials Management & Insurance A/R Follow-Up: Understanding denied claims and how they drive A/R days and staffing allocation

Accreditation and Certification

Accredited Health Utilization Management USA
Accredited Health Utilization Management Philippines
Accredited NCQA Case Management 3 Years
Accredited NCQA Case Management Utilization Management USA
Accredited NCQA Case Management Utilization Management Philippines
HITRUST Badge