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Investigation and Recovery Services |
| Avoid overpayment of claims with our combination of prospective detection and investigation services which discover errors before the claim is paid and retrospective fraud and abuse services, including expert evidence analysis, interviewing, medical records review, and case documentation to help you recover your losses.
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Services to help you:
- Prevent payment on erroneous claims
- Discover potentially fraudulent claims
- Recover overpayment losses
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Products:
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Fee Negotiation Services
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Newly acquired, Innovative Cost Solutions (ICS Healthcare) now provides Ingenix Fee Negotiation Services. These services include both Pre-claim and Post-claim services for medical claims payments outside of traditional contracted providers, including non-network or non-participating providers. We also specialize in ER admissions, acute care, skilled nursing, and home health cases as well. |
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Hospital Bill Audit Services
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Ingenix Hospital Bill Audit Services help health plans reduce costly inpatient hospital billing errors by revealing duplicate charges for a single service or item, charges for services never performed, and incorrectly calculated room or pharmacy charges. |
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Hospital DRG Audit Services
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Hospital DRG Audit Services enable payers to develop an initial provider-level benchmark DRG analysis/audit and institute both retrospective and ongoing audit and recovery programs. |
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Overpayment Recovery Services
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With the recent acquisition of J.W. Hutton, Inc., Ingenix now provides Ingenix Overpayment Recovery Services, a comprehensive recovery service based on a client-focused collection methodology that helps build better relationships with providers. |
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Prospective Investigation Services
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Ingenix, a pioneer of the pre-payment detection and investigation process, offers a comprehensive service to identify fraudulent and abusive claims for investigation before the claim is paid. |
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Retrospective Investigation and Recovery Services
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As an established leader in the field, Ingenix offers comprehensive retrospective fraud detection development and recovery services that include all aspects of the process—from the initial referral receipt to the final recovery settlement. |
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Subrogation and Injury Coverage Coordination
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Accident-related medical claims typically account for 8-10% of a health plan’s claims volume. Ingenix helps identify, investigate, prevent, and recover payments linked to accident-related medical and disability expenses. |
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Questions?
To discuss how we can help your organization, please contact us:
engage@ingenix.com or
(800) 765-6713 |
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