Validate your Revenue Recovery

Valetude Account Settlement is an underpayment tool that allows the user to perform additional audits on patient accounts by comparing the estimated reimbursement (as calculated by Valetude) to the actual reimbursement received.  The Valetude reimbursement calculation engine applies contract rules to patient charges resulting in an expected reimbursement amount calculated by Valetude.  This amount is backed up by a detailed line by line summary of how a contract was applied to a patient’s charges.  The relational database is then used to identify specific patient accounts that have variances between what is expected and what was actually received by the hospital.  Your staff is well equipped to contest payment errors by focusing their attention on these variances and providing them with detailed backup of the contract application on a case by case basis.

 

 Targets for rebilling include:

  • Change in DRG after original claim
  • Contract interpretation difference with payer
  • Secondary payer reimbursement higher than primary (ensure secondary claim and payment)
  • Incorrect procedure/CPT billed
  • Actual payment less than anticipated
  • Inappropriate refunds or payer take-backs
  • Inappropriate write-offs

 

 

Service

Accessible and Responsive

Business Analytics

Visualize Results and Focus Efforts

Prototyping and Assessment

Minimize Risk with Proven Results

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