Retrospective Record Review

A payment integrity solution for payers who want to maximize overpayment recovery, reduce payment waste, and promote provider satisfaction.

What’s included in Retrospective Record Review

  • Diversified audit portfolio

    • Select from several audit types
    • Support sequencing in accordance with standards
    • Powerful data analysis and screening
    • Helps minimize provider appeals
  • Provider-friendly, flexible approach

    • Tailored to payer reimbursement policies
    • Web portal for on-site or remote audit recovery
    • Obtain signature verifying audit acceptance
  • Experienced audit professionals

    • Expect expertise, professionalism, and accuracy
    • Delivered accurate audits for 6,500+ hospitals
    • Staff auditors average 15 years of experience

Drive efficiency and automationwith Retrospective Record Review Services

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Maximize audit recovery

We identify inaccurate coding, inappropriate level-of-care billing issues, and contractual reimbursement errors, and then work with you to help ensure all valid overpayments are recovered.

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Predictive analytics and industry expertise

Our audit recovery tools allow you to work collaboratively with providers to obtain their sign-off on payment recoveries and claim audits — all while promoting maximum medical claim recovery. Review complex medical records and control rising costs associated with medical claim recovery and help minimize provider appeals.

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Seamless integration with existing workflows to drive efficiency

Drive efficiency and automation with tools tailored to your reimbursement policies and methodologies. Seamless integration allows you to maximize audit recovery without interrupting your current processes. The ability to address a full spectrum of claim types can allow you to mitigate future risk and exposure.

Our outcomes

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  • Explain our features, benefits, and services
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