inpatient accuracy

reduce improper high-dollar inpatient claim costs

view the fact sheet

Verscend offers complex catastrophic hospital claim review. These claims are reviewed by a team of certified coding experts, who reconstruct the course of care from a clinical perspective and then identify gaps between the care provided and the charges billed. We focus on complex hospital claims that represent one to two percent of total hospital claims but account for 12 to 15 percent of our clients' hospital spend.

The results? Verscend saved one client $3.9 million on total identified charges of $21.3 million (18.3 percent) in 2015, and another $2.2 million on $13.6 million in total charges (16.3 percent) in 2016*.
*Based on a hypothetical scenario built from actual client results. Individual results will vary by client.

features

  • Claim selection to meet each client's criteria for review
  • Claim summary supported by line item documentation
  • Facility bill negotiation and appeal support
  • Savings and trend reports
  • Line-by-line review

benefits

  • Promote payer and provider transparency
  • Respond to appeals quickly and precisely
  • Increase claims payment accuracy rates
  • Integrate seamlessly with your existing editors
  • Implement our easy to use system simply and smoothly

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