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Giant health care insurers and mid-size to large corporations can improve profits by recovering money after health insurance claims are paid. Health Decisions Inc. a national leader in group health claim recovery, serves commercial insurers, HMOs, self-funded companies, consultants, brokers, union trusts, and government entities.
Plymouth, MI (PRWEB) October 6, 2004 — A Plymouth company has positioned itself at technology’s edge so it can assist giant health care insurers and mid-size to large corporations improve profits by recovering money after health insurance claims are paid.
Health Decisions, Inc. has the power to review claims already paid and find enough income in unpaid claims to produce up to a 10-1 return for clients.
“Our company is a pioneer as we are the first and only one involved in Post-Payment Administration,” explains Si Nahra, PhD, President of Health Decisions, Inc. of Plymouth. “After everyone else is finished, we apply our expertise, methodology and powerful software tools and dig even deeper to uncover more money for self-insured employers and health insurance companies.”
Post-Payment Administration, akin to unscrambling the egg, finds money to recover after health claims have been paid by insurance companies or self-insured corporations.
Each year Health Decisions investigates over $250,000,000 in claim payments and identifies a recovery potential of 1-3%. Health Decisions’s software is so powerful that it identifies more recovery cases in an hour than manual reviewers can do in a week.
Health Decisions, a national leader in group health claim recovery, serves commercial insurers, HMOs, self-funded companies, consultants, brokers, union trusts, and government entities.
Among its client lists are Blue Cross Blue Shield of Michigan, IBA Health Plan, Compuware, Detroit Diesel Corporation, Elias Brothers, General Motors, Kellogg Foundation, MASCO Corporation, Michigan Beer & Wine Wholesalers Assn., R.L. Polk, Oakwood Health Services, St. John Hospital, the cities of Detroit, Ann Arbor, Pontiac and several school districts.
“When we take a look at the last 2-1/2 years, Health Decisions has recovered in excess of $128,000 for only $52,000 in expense,” says Richard A. Gasowski, director of risk management and safety for Macomb County.
Health Decisions goes much deeper, seeking claims to recover by conducting a review of 100 percent of claims in more than 30 areas to identify and recover claims paid that are not the client’s responsibility. This service routinely produces a positive return-on-investment, says Nahra.
In addition to claim recovery, Health Decisions conducts a formal audit of claim payer procedures and performance and identifies and corrects errors or omissions made by claim payers that are increasing plan costs and legal liability.
Health Decisions also offers specialized staff to conduct a complete Enrollment Verification Survey of all covered persons with the full range of information needed for claim administration and regulatory compliance, including new HIPAA regulations.
