AmeriVeri identifies miscoded medical claims before payment is issued. Individual claim lines that contain errors are recommended for non-payment. In order for a provider to be paid for their services a claim must be resubmitted. Whether a claim is resubmitted correctly, incorrectly, or not at all varies by provider and follows no pattern.
Note: If the resubmission rate is high, we ensure the accuracy of a significant number of claims. If the rate is low, we save significant money for employers and payers.
Data Feed: Data sent back to the client is tailored to preferred format. (e.g. 837, comma delimited, etc.) This format does not have to match incoming format.
Reports: Line by line details that include reason codes and descriptions accompany every return data file.These reports can be customized for individual clients.