Managed Care Program

Our audit specialists review the hospital's reimbursement history starting from the contract payers and verify that the contractual terms and conditions are being satisfied. Our Managed Care Audit Program addresses both past and current claims for accuracy.

American Medical Review provides all staff for follow-up and collections to ensure reimbursement. A report of recovery results and pending claims will be provided to the hospital.

American Medical Review's Managed Care Audit Program includes reviewing current contracts for coverage exclusions and inclusions that would result in lost revenue.

Program Objectives:

• Recover lost hospital revenue
• Reduce contractual write-offs
• Isolate payment variances and their causes
• Reduce risk of future underpayments

View Examples:

• View Sample Managed Care Review Results
• View Example CCA Form (Contract Compliance Analysis Form)

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Do you know?

How much revenue you are losing annually on your Managed Care Contracts.