Healthcare fraud, clinical coding errors, and data transformation challenges cost health plans between 1-3% of total medical spend, decreasing margins, and forcing health plans to cut member benefits, raise premiums or reduce provider reimbursement. It is estimated that over 20% of each Medicare dollar goes toward payment of fraudulent or inaccurate claims.
HDVI has worked with thousands of providers in over 25 states to collect relevant member data contained in charts or other provider records.
HDVI provides analytic solutions to help better audit providers on payment-related issues. Using customized algorithms, either from your internal systems, your analytics vendor, or from your (RAC) Recovery Audit Contractor, HDVI provides the software platform and needed services to identify, locate and review provider records. HDVI has worked with thousands of providers in over 25 states to collect relevant member data contained in charts or other provider records. Keep a better eye on your medical loss ratio, and let us ensure that your payments are for valid and auditable services.
