With our medical claims analysis service, clients send us their claims with supporting documentation and our diverse team of trained healthcare professionals get to work, performing a deep dive into the data.
They perform accurate, consistent comparison and analysis to identify coverage criteria mistakes and concerning trends that could negatively impact a client's bottom line, compliance with rules and regulations, and the delivery of high-quality care.
Here are just some areas we focus on during our claims analysis:
- Inconsistencies between billable services & documentation
- Medically unnecessary services/procedures
- Inefficiencies resulting in waste
- Services or supplies not provided
- Duplicate services or supplies
- Utilization trending
We understand that every client has different needs and challenges. That's why our claims analysis service is customized for every client engagement. We can provide ongoing analysis of claims or process a single batch — no project is too big or too small.
Our reports provide the level of detail needed to bring about changes, and do so fast. The Veritas team is available to assist clients in reviewing claims information and medical record documentation, as well as planning ways to address concerns and implement lasting improvements.
Want to learn how our claims analysis service can help you achieve your financial, quality, and compliance objectives? Contact us to learn more.
Note: Our team may be in a position to assist your organization with work related to but outside of the scope described above. Learn about how Veritas "Special Projects" deliver services tailored to meet specific job needs.