HMS' Clinical Claim Reviews leverage a vast knowledge base from clinical experts, credentialed physicians, and healthcare data scientists to improve payment accuracy and minimize pay-and-chase.
Episode of Care is a semi-automated payment accuracy solution from HMS that analyzes a patient's claims history related to an episode of care to identify discrepancies and recover overpayments.
Here are the most frequently asked questions about HMS' Episode of Cares solution.
Here are the most frequently asked questions about HMS' Genetic Testing solution.
HMS' suite of Medicare Advantage services are designed to help MA plans overcome industry forces that create pressure to optimize revenue, reduce costs, minimize risks, and improve outcomes.
Here are the most frequently asked questions about Pre-pay Clinical Claim Review.
Inpatient hospital readmissions are costly for all payers. HMS can target readmission pairs in which the claims data indicates the second admission is for the same or similar condition.
Incorrect payment of genetic test claims persists despite preauthorization programs. HMS offers a solution that generates significant savings by increasing payment accuracy for genetic testing.
ER Billing Compliance is a payment accuracy solution from HMS that addresses inappropriate ER Level 5 billing.