Closing the Gap
In this day and age, nearly all medical claims are reviewed for code errors in some way or another. Insurance companies, third-party administrators and claims processors all have systems with built in features for identifying medical code errors. However, these standard reviews lack in several areas costing patients and consumers millions of dollars each year.
At AmeriVeri CR, our focus is to close the gap by identifying these errors before claims are paid. From experience, we can estimate that inaccurate medical claims may account for as much as 4% of annual health care spending in the United States.
Medical Code Clearing House
As mentioned, insurance companies and third-party administrators do review claims for coding accuracy. However, medical coding is only the tip of the iceberg when it comes to the many roles filled by claims processing organizations.
Our goal as a Medical Code Clearing House is to assist these companies in saving their clients money. By complementing their current adjudication and code review processes we help find additional savings for them and their clients. At AmeriVeri CR, our only focus is the medical code as it stands today. We do not check for benefits or eligibility.
The AmeriVeri CR Advantage
Until now, the claims processing systems mentioned above have been unable to remain current. Annual and semi-annual updates have been the norm while coding practices change far more often.
In order to consistently find additional savings for our clients we update the AmeriVeri CR system much more frequently. As medical codes are created and changed from day to day we too are updating our databases. The currency of our working code sets allows us to review claims based on the medical code as it stands today.
Additionally, the AmeriVeri CR system captures the full intent of all codes making our approach truly comprehensive. In all applications to date, AmeriVeri CR has identified incremental savings for its clients, generally representing significant amounts.
