Our Advanced Error Detection provides clinical editing technology to ensure that both institutional and professional claims are appropriately coded and compliant with applicable payor requirements. On average, we detect billing errors containing dollar savings opportunities on 3% to 8% of your claims, depending on the claims process. Our clients generally save between 2% to 5% of their entire medical spend.
• Examines the whole claim
• Identifies unbundling occurrences
• Procedure-to-diagnosis mismatches
• Use of nonspecific diagnosis codes
• Global service violations
• Potential unbilled revenue
• And many other problem areas
Integrating with A&G is simple and straightforward. We're already partnered with all major claims adjudication systems such as Eldorado, Ebix, WLT, Trizetto, and many more. Have something home-grown? We're happy to work with you to create a custom solution for your current claims system.
Sometimes 'one size fits all' solutions are too rigid to integrate smoothly into a company's workflow. A&G's Advanced Error Detection can be set up in a variety of ways to fit your needs to ensure there's minimal to no disruption to your current processes. Deployment is available via web API, desktop client, or batch file, depending on your adjudication system. Customized edit rules can also be created to meet your needs, whether it's a particular provider or a group.