M2 MedMatch offers healthcare providers a value-added service known as retrospective revenue recovery. By deciphering Payor Claim Status Groups and Reason Codes, then reverse engineering, Payer Details, and Adjustment Information, our Team analyzes zero-balance insurance accounts and recovers your unclaimed revenue.
The New Revenue Stream
Added Directly to your Bottom Line
Recover Lost Insurance Revenue from Aging, Inactive or Closed Write-Offs Accounts
Payors realize that few healthcare organizations have the staff, time, or information technology required to routinely CHECK their payor remittance advice and MATCH patients' benefits and eligibility, resulting in lost revenue.
We scrutinize payor logic issues, rules, edits, and remark codes and use our knowledge to get your claims reprocessed.
Many of the insurance charges we appeal have been previously rejected and written off by the providers. It takes an experienced and dedicated unit to recover your unclaimed revenue.
Directly to You
Denials | Current Claims or Retroactive Recoups or Offsets
We adjust such issues as unauthorized discounts, wrongful denials, downcoding, bundling edits, underpayments, and recurring delays, detecting and reducing trendy and harmful auto-adjudication tactics.
Our compliance team verifies patient coverage, policy, and contractual information, enabling us to identify which payors owe you money. Collecting lost insurance revenue requires vigilance, attention to detail, extra time, labor, and financial resources.
Identify Payor Auto
Payors utilize countless internal and external sources (data scrubbing, algorithms, and non-applicable reimbursement methodologies), including summary plan description and insured policy misinterpretation, to impose systematic or arbitrary claim reductions and denials to current and past accounts receivable.
Our focus is on the specific plan documents and notable policy exemptions that are typically overlooked and misunderstood.
Edits Diminish Profits
Systemic or Isolated Underpayments & Unauthorized Discounts
A Silent PPO is-an entity that accesses discounted rates for services from a physician, hospital, or other health care provider without the provider's direct authorization.
Instead, networks resell to other buyers, or middlemen referred to as repricing brokers, to obtain the lowest discounted rates even though the patient is not directly a member of your contracting plan. The Silent PPO applies those Unauthorized Discounts to your bills and shares a percentage of the Underpayments.
We have identified many of these Silent PPO companies and reversed those arrangements, restoring unclaimed money from previously reviewed or closed accounts.
"Re-Pricing" Your Bills
Analytic Feedback of Billing & Coding Procedures
We possess cardinal knowledge and experience that enables us to examine managed care contracts, address payor reimbursement issues, and gain thorough insights into credit balance forwarding (recoups).
We offer recommendations for submitting clean claims, which can help to ensure timely payments and improve your revenue cycle.
Clean Claims Fuel
Revenue and Cash Flow