About 1% to 3% of net hospital revenue is commonly lost due to insurance underpayments and invalid denials. Our seasoned team works with you to develop a payment compliance monitoring system that relies on robust contract modeling to identify the true value of the services you provide based on your contracts and the care provided. Precise reimbursement modeling enhances net revenue accuracy, identifies lost revenue and provides visibility into adverse reimbursement trends. By identifying and resolving inappropriately underpaid claims and denials, we work collaboratively with you to improve collections and cash flow–and your overall financial health.
We recover more than $650+ million annually for clients through real-time management and resolution of payment discrepancies and denials.
Our effective protocols and technology give you the ability to better predict revenue because you know what you can expect.
Improve your awareness of outdated protocols causing payment discrepancies through analysis that’s benchmarked with 250+ top-performing hospitals.
A 15-hospital system faced a high percentage of denied and underpaid claims, as well as aging technology and outdated protocols, resulting in consistent revenue shortfalls.
Parallon partnered with the client to develop a new payment compliance system, update technology, leverage best practices and establish proven resolution protocols. Parallon conducted a root cause analysis to identify internal process refinement opportunities and hold payers accountable for actions that violate the agreed upon terms of the provider contract. In addition our experts pursued underpayment recoveries and overturned denials.
$20M in incremental net revenue