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

Treasurer Customer Quote

"The HR Best Practices reconciliation software enables us to identify eligibility-based errors before it’s too late to recover overpayments".