A major contributor to decreasing net revenue is underpayments by managed care organizations. HFRI’s Clinical and Utilization Review teams and contract specialists are a very important additional value to our clients. HFRI specialists will review all suspected underpaid claims for compliance with the terms of the payer contract to ensure the maximum allowable reimbursement is received. If there are any discrepancies, HFRI will appeal for additional reimbursement.
HFRI’s clients have recognized direct referral of denied and underpaid claims can increase net revenue, decrease bad debt/uncompensated care and, perhaps more importantly, improve patient goodwill.