Claims Review and Resolution
ClinAssist Program Overview
Claims payment has become more complex, particularly for large dollar claims. With the dramatic rise in auto-adjudication and billing errors, payers frequently miss major opportunities for significant savings that can greatly impact their bottom line.
ClinAssist is the leader in complex claims review and resolution, offering payers a complete solution, from initial screening through settlement. ClinAssist employs a state-of-the-art process, hands-on clinical and financial experts and proprietary algorithms to achieve exceptional results.
Conventional medical record audits typically focus on matching services billed to physician orders, resulting in average savings of about 4%. In contrast, ClinAssist's average savings is 21.2%.* The Assist Group has a 93% uphold rate through resolution and signoff of our Forensic Review findings.
