Our Process
Health Decisions provides Post-Payment Administration. We start after everyone else is done.
Our services help recover 1-3% of paid claims. Our findings help management monitor performance progress and identify areas in need of attention. Paperless Case Review and collection can be outsourced or done by internal staff using our suite of software tools.
Our services help recover 1-3% of paid claims. Our findings help management monitor performance progress and identify areas in need of attention. Paperless Case Review and collection can be outsourced or done by internal staff using our suite of software tools.
Our software tools:
- Take 100% of paid claims (with associated enrollment and administrative data);
- Validate and combine these data to create a new data asset;
- Add to this asset new information from a variety of sources;
- Analyze all data to identify cases warranting recovery follow-up;
- Support that follow-up via secure, HIPAA compliant communications;
- Follow all potential recoveries (from any internal or external source) until resolved; and
- Provide a full range of routine and custom reports.