Overpayment Recovery Audits

With our Overpayment Recovery Audit, HDM validates claim errors, identifies overpaid claims for clients and provides the results to the administrator for recovery.

We’ve found that overpayments often result from duplicate or similar claims, coordination of benefit errors, and provider posting errors.

HDM then takes the additional step to assure full recovery for our clients by working directly with providers to increase the recovery of payments for claims that a third-party has reimbursed.

HDM also negotiates and monitors recovery collection activity to assure that all recovered dollars go to our client. By taking these steps and identifying these errors and cost savings, clients are also able to lower medical loss ratio, lessen provider appeals, and increase earnings per share.

Validation
HDM has developed analytical tools that identify claim errors and overpayments. HDM auditors perform onsite audits to validate findings.

HDM Involvement
HDM validates errors and overpayments, presents findings directly to the administrator and will negotiate with the administrator to resolve all findings.

Tracking Recoveries
HDM finalizes all audit findings with each administrator and tracks recoveries to ensure payments or offsets go to our clients.

To discuss how HDM’s cost containment solutions for self-insured employers can benefit your organization, contact HDM today at 800.859.5119 ext. 1 or e-mail your inquiry to: info@HDMinc.com.