GREENWOOD, Ind., Jan. 18, 2016 /PRNewswire/ — AmeriVeri (http://www.ameriveri.com/) is on a mission to take a significant chunk out of the waste and errors that contribute to healthcare overspending. The company’s flagship software-as-a-service solution finds medical coding errors that would otherwise go undetected, providing a critical last line of defense against improper payments and inaccurate medical records. AmeriVeri’s service therefore delivers measurable and meaningful benefits to every stakeholder in the healthcare system.
According to the Centers for Medicare and Medicaid Services, healthcare spending in the U.S. topped $3 trillion in 2014; there’s no reason to think that 2015 spending did not grow by several percentage points. Healthcare spending represents about 17% of the national economy. Much of the recent growth has been thanks to insurance coverage expansions made possible by the Affordable Care Act. When dealing with such huge numbers, even small medical billing and coding errors can add up to significant waste.
The proprietary service developed by AmeriVeri detects medical coding errors routinely missed by every other adjudication process. On average, the service identifies two errors per every 100 lines of code. Using a conservative estimate of just one percent, AmeriVeri can rightly claim that its verification solution, when fully implemented, could save $6.5 billion each year for payers and employers while providing significant accuracy enhancement to providers.
“The revolution of electronic medical records has not delivered on all of its promises,” explains AmeriVeri VP of Operations Martin Amberger. “Namely, electronic records have not eliminated the problem of coding errors. Our proprietary process goes a step beyond standard adjudication processes with its Medical Necessity and Service Verification Component. The intent of the codes used is an important factor that others neglect – AmeriVeri can pick out individual lines that do not warrant payment. Payers and providers can then decide how to proceed with that feedback. ”
AmeriVeri’s service applies to $650 billion of the $3-plus trillion healthcare sector. The service offers tangible and immediate benefits in the form of increased accuracy of medical claims and histories, which contributes to a patient-centered model of care. As for capacity, AmeriVeri can process nearly one million claims in fewer than 25 minutes, and all data is encrypted and confidential, both at rest and during transfer.
The AmeriVeri SaaS solution is available to insurance and reinsurance carriers, TPAs and bill review providers. The service functions as a final accuracy check in the processing of group health, workers’ compensation and Medicaid claims. AmeriVeri integrates with any adjudication software and can be deployed at any point in the workflow.
The cost and consequences of medical coding errors go beyond a simple dollar amount. For a small practice, too much lost revenue resulting from unbilled services can lead to inefficiency and bankruptcy. Likewise, excessive errors can draw the attention of regulators or be used as evidence in malpractice cases. Physicians and hospitals thus have powerful incentives to achieve 100% accuracy, yet the rules and procedures are dynamic and complicated. AmeriVeri tackles this challenge through complete compliance with all contemporary coding standards.
From the patient’s perspective, accurate coding results in a higher quality of care. Errors in medical history can ultimately lead to improper diagnoses and treatments, which factors into the rampant overspending, not to mention leading to unsatisfactory outcomes for patients. AmeriVeri seamlessly addresses all of these dimensions.
AmeriVeri strives to make implementing its service as effortless as possible – there’s no software to install, and payment is completely transparent. Clients can choose to pay for services based on a net percentage of savings created or on a per-claim/bill basis. Either way, clients can easily see and understand how much revenue is being saved via AmeriVeri’s SaaS verification process.