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Typical Results

Typical ResultsBased on a coding compliance auditing model, the average projected yearly savings can be as high as $6 million of verified over-payments for every 100,000 members in a DRG payment environment (based on a blend of Medicare, Medicaid, and commercial lines of business, and geographic variations in DRG base rates).   On average, a 40% - 60% reduction per claim of the originally billed amount is achieved.  What’s more, the first year of auditing can yield up to triple the typical savings due to  CMS regulations that provide eligible Plans a three (3) year look back period  for historical claims. This is “found money” to a Plan’s bottom line and a scaled up return for the start-up service period
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