Claim Recovery

Numerous studies have shown, that in many cases healthcare insurance claims are not filed against the proper or ideal insurance carrier (i.e. Healthcare plan billed instead of auto insurance plan). As a result, Hospitals are not being reimbursed the total potential revenue that they should have received for their services. In fact, in a 2015 Government Accountability Organization (GAO) report, the committee reported that 10.5% of the payments made by Medicare alone, equating to $59.9 billion US dollars, were wrongfully covered by CMS and should have been covered by other third parties.

Our partner Claim Recovery company specializes in identifying claims that were improperly submitted and paid, and rectifies the situation by finishing the cycle through the collections process. Their cutting edge technology solution simplifies the complex, labor intensive processes required for Hospitals Managed Care companies, ACOs and Physicians to get paid more for third-party liability related medical claims while being able to determine the appropriate monies to return to the medical organizations that initially paid out the claims.

Utilizing proprietary software developed with advanced algorithms to analyze a Medical Organization’s claims and payments data files, they help maximize the revenue returned to the Medical Organization by identifying potential revenue leakage retroactively on claims. They determine the status such as: collectible, noncollectable, underpaid, or in self-pay status and subsequently deliver revenue back to the Medical Organization.  Their proprietary system’s advanced analytics cross-reference the file against 50+ proprietary databases along with 20+ publicly available databases to identify claims with potential revenue return on a retroactive basis, according to the statutes of limitations in the respective state that the claim was processed. 

They have a proven track record in doing claim recovery and we have consistently found more revenue than any other vendor with whom they compete, including internal departments who attempt to accomplish this themselves.

A few key facts and bullet points about our Partner:

•  $250+ Million Recovered for Hospitals and Health Plans

•  Revenue Recovered amounts from 1-3% of overall claims

•  No out of pocket or upfront expenses to our clients

•  Clients in 46 States / 1000+ Hospitals including top Health Systems    

•  Proprietary discovery solution leveraging 70+ sources of key information

•  No Patient Contact ever

•  Proprietary Process to recover lost funds through identifying proper coverage

•  Analyze all zero balance accounts retrospectively

•  Have recovered significant revenue for clients 100% of the time regardless of other vendors or in house solutions       in place

•  Do not have to replace any existing processes or vendors; but rather enhance those efforts as an additional               solution

The most intriguing and attractive aspect of this service is that they work exclusively on a contingency basis.  They can run analytics on the client’s existing data in its simplest form and have a report back within days outlining the lost, yet recoverable revenue.  All they need is the claims (835) and payment (837) files and they can go to work.

This unique opportunity is available for a short time as a result of the questionable overcharge practices of your current or former medical waste vendor Stericycle. Your invoices from Stericycle may have been increased by as much as 18-24% annually without your knowledge. There are two questions to be answered:

  1) Did you ever use Stericycle for your medical waste management?

  2) Would you like us to recover money for your company?

Most of our clients were, or still are, Stericycle customers, and have signed contracts with as much as 6% increases per annum. In the mid 2000’s, Stericycle started using a software package called TOWER. This program applied automatic and regular cost increases in amounts of 18-24% to all of Stericycle’s Customer base, which is why you were likely overcharged as well.

Our proprietary software, legal and accounting teams are designed to efficiently determine very quickly as to whether or not you have been subjected to Stericycle’s software illegal over billing arrangement. We will review your Stericycle contract/s and Stericycle Payment Summary, respectively, to determine whether there is an actionable collection present. We have already identified millions of dollars of Stericycle over-billing to hospitals, laboratories, medical, dental and veterinary clinics.  

All we need is your contracts with Stericycle and your payment summary to Stericycle for the term of the service provided. We should be able to collect the funds within 6 months. The call to action is VERY real and significant. Because very soon this Stericycle over-billing arrangement is going to be certified as a class action case. The time to act is now because once it is certified as a “Class” the amount of your loss you will be able to recover will be drastically reduced and it will take 3 to 5 years to get a dime.   

Please Note: Our services are performance based only and we only make money on successful collections recovered for your business.

If you wish more information please contact Ancillary Health Services at 954-689-2225


FINANCIAL SERVICES 

Stericycle Recovery(overcharges)

We provide custom financial solutions for all types of medical organizations, but our Claim Recovery services are most appropriate for Hospitals, ACOs, other Self Insured Organizations or Health Plans.


We have very successful, proven, cutting edge solutions which identify and recover revenue on a contingency basis with no upfront cost or risk to the organization.