CLEAN CLAIM REVIEWS
Correct Erroneous Billing
Average savings of 16% or $22,000 per claim
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THE HIGH COST OF HOSPITAL CLAIMS
Hospital claims account for over a trillion dollars in annual healthcare spend in the US, making claim reviews and proper payments paramount to eliminate waste in the system. Payers require expert partners who understand the complexity of billing and payments.
At 6 Degrees Health we offer prospective and retrospective solutions that deliver best in class savings while preserving the health plan’s relationships with providers.
$1000000000000+
CLEAN CLAIM REVIEWS
WHAT THEY ARE
Clean Claim Reviews, also referred to as itemized bill reviews (IBR), are a component of our Payment Integrity program that provide detailed clinical reviews of inpatient hospital claims powered by Fennec, a next generation claim review platform, and include full support through disputes and appeals with providers.
Payment integrity is about adherence to standard billing practices and accountability at every level; to identify and eliminate errors or inconsistencies and ensure claims are paid accurately the first time.
Our next generation Clean Claim Reviews leverage clinical expertise, cutting edge proprietary technology and best in class services to drive comprehensive claim reviews and ensure claims are accurate prior to payment.
WHY THEY’RE IMPORTANT
Clean Claim Reviews are paramount to ensuring high dollar inpatient claims are paid accurately to reduce waste in our healthcare system and the trillion-dollar annual hospital spend in the US.
100% OF INPATIENT CLAIMS HAVE BILLING ERRORS
There is also a significant discrepancy in billing across hospitals – without clean claim reviews, health plans and patients can be overcharged, contributing to billions of dollars in waste for the healthcare system.
NAVIGATING PAYMENT INTEGRITY
Explore insights and predictions for the future of the Payment Integrity industry with Katy Brant in her exclusive interview to solve your high dollar claim challenges today.
LOW PROVIDER ABRASION, EXCELLENT SAVINGS
WHY CHOOSE US
Our expertise provides the highest level of savings in the industry with comprehensive support and defense. Our Clean Claim Reviews leverage state-of-the-art technology to deploy proprietary rules, which enhance our in-depth registered nurse reviews. We conduct our reviews in accordance with industry standard guidelines, evaluating every line item to identify and eliminate billing errors and inconsistencies.
CLEAN CLAIM CASE STUDY
SUBMIT A CLAIM FOR REVIEW TODAY!
Send us a claim over $100,000 and we will show you how much you could save.
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Our team can help you find the right solution.
