Audit Payer Performance

Simplify the tangled web of contractual agreements, insurance rules and regulations

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Client Video: Duke Private Diagnostics Clinic

Timothy Daye with Duke Private Diagnostic Clinic talks about how Experian Health's Contract Manager reduce underpayments and the costs associated with appealing those underpayments.

In an ideal healthcare world, third-party payers would always make payments accurately and on time. Unfortunately, human error is unavoidable, so missed payments and underpayments happen. Identifying and correcting these inaccurate payments often falls to healthcare providers, and without a strategy to make sure payers are complying with your contract terms, these errors are bound to cause stress and volatility to your revenue cycle.

Simple human error is also the main reason why medical claims are denied. The smallest typo or discrepancy can lead to an immediate denial, and reworking a claim rarely increases its chances of being more accurate. Streamline claims management by checking that every claim is clean and error-free before the provider submits it, eliminating the costly, time-consuming need to redo them. Fewer denials (and, therefore, fewer reworked claims) mean a faster and more predictable revenue cycle, as well as lower administrative costs and more time for staff to focus on patient care.

You need automated access to the right data. Our solutions help you get reimbursed accurately and fast, while strengthening your relationships with payers.

Experian Healthcare Automated Payer Alerts

Avoid payment delays and lost revenue with automated payer policy and procedure change notifications.

Contract Manager and Analysis

Audit payer contract performance to assure compliance—and maximize revenue.

Scripps Clinic client success story

Learn how $10.6 million in underpayments was recovered in 9 years

Client Video: UCLA Health System

UCLA Health System Faculty Practice Group has implement Contract Manager and Analysis to, not only recoup $3.5 million dollars in underpayments from payers, but also to catch Medicare overpayments faster to lower their risk of compliance issues.

Client Video: University of Iowa Hospitals & Clinics

Learn how University of Iowa Hospitals and Clinics saved time, money, and headaches by implementing a contract management system that monitors payer compliance with contract terms, value claims, and audit remittances based on the latest payment rules and adjudication logic.


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