HR Best Practices

Containing Health costs through Data Mining

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For Plans, Payors and Carriers

  • Do you have 100% confidence you’ll pass the next eligibility-driven claims audit?
  • Would you like to improve the power of your marketing messaging?
  • Are you interested in reducing your medical loss ratio?
  • Does the idea of a new revenue source (dependent audits) interest your management team?

HR Best Practices is a leading eligibility-driven claims auditing and cost containment organization. Everyone in the plan, payor and carrier industry knows that eligibility is a challenge that few, if any, organizations get right. As a result, tremendous revenue and profit exposure exists.

Our technology is available as a branded, co-branded or private label solution. Our HRBP 2.0 web technology provides a “one-button” solution. Essentially, at the push of a single button, numerous business rule-driven queries are executed simultaneously. Users are then free to review and validate suspects. Since our user interface is designed using web 2.0 technology, our solutions can be mastered in a few hours.

In today’s highly competitive climate, plans, payors and carriers cannot afford for eligibility-based leakage to adversely effect their business nor can these entities afford to ignore profitable, revenue-growth opportunities.

 
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NEWSFLASH:  Subrogation specialists “estimate that between 1% and 3% of health-care spending is potentially recoverable to the health plan.” Wall Street Journal, November 20, 2007 Read More (subscription required) - Learn More about Subrogation


Customer Quote

Chief Internal Auditor

“HR Best Practices goes beyond the normal practice of manual sampling and testing of claims by using advanced software they have developed to do extensive data mining and analysis of your full population of claims.  The HR Best Practices team is not only expert in the health care field; but the team also has a real passion for healthcare auditing and cost containment”.