Challenges

What is wrong with today’s recovery model?

What are the challenges you face with your current recovery and cost containment process.

Generic, industry standard algorithms.

How many times have you heard a new vendor say they have a new, special set of algorithms that are better than everyone else? It’s been decades of the same approach, with only marginal improvements.

It’s time to join the process revolution. Use your claim, call, audit, and configuration data – all into your customized rules engine funnel for recovery and cost containment. Are you ready to stem the overpayments and triple your recover dollars?

Pay and chase dollars.

You adjudicate claims, then rely on internal and external recovery teams to try and claw the money back while not upsetting your providers and member. How is this improving member and provider satisfaction?

With ClaimTarget rules engine we cast a net over future claims in progress to prevent payment errors from going out the door. At the same time we data mine overpayment, identify root cause, and manage the corrective action to stop the future payment problems.

No integration with other departments.

In most shops today, audit and recovery are, at best, marginally connected functions. If your call center identifies a payment error, or quality audit team finds a configuration problem, are they tied to cost containment?

End to end connected workflows. On our platform, you can see the recovery process from provider call all the way through to recovered claims. The workflow, process handoffs, data integrations, and analytics are all connected.

No incentive to reduce payment errors.

Let’s face it, your recovery vendors are in the business of using standard, dated algorithms to find the same problems over and over again. They get paid for this, why would they want you to fix your problems?

Our success is tied to your success, not your failures. Every rule in ClaimTarget automatically ties to a corrective action to fix the root cause. Claims are checked prepay to catch and fix payment errors before they go out the door.

Relationship

Up and Running in 30 days.