We Service a Variety of Businesses and Entities. Find Yours Below.

Self-Insured Companies and Unions

crowdHow often does your TPA get you refunds from providers and/or credits from benefit overpayments? Due to the complexity of medical billing guidelines, it would be impossible for TPAs to scrutinize every claim your company receives. MRS analyzes your claims payout in areas your TPA couldn’t possibly have the time, staff, and/or program edits to accomplish, and typically finds overcharges–and overpayments–of six and seven figures for a single plan year.

Attorneys

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Our in-depth audit methodology not only ensures that facility billings conform to the medical record by our Medical Record Audit, but also identifies fraudulent and abusive billing practices by our Compliance Audit and prices that are in excess of what is fair and reasonable by our Fair & Reasonable Price Analysis. We can then translate our findings into testimony that can help your case.

Providers

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Denials and/or delinquent payments of claims by insurance companies have become a serious problem for many providers. Physicians are being forced to allocate time and resources to follow up with insurance companies; resources that could otherwise be spent on patient care. When we review the billings, we look long and hard at the patient’s insurance policy to make sure the insurance company pays everything they’re obligated to pay. More often than not, we find the insurance company has underpaid. MRS has medical billing consultants to assist with your billing.

Federal, State, and Municipal Government

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According to the Centers for Medicare & Medicaid Services, healthcare fraud contributes to a staggering amount of cost in the medical industry. Healthcare fraud investigators participate in many sponsored national anti – fraud programs to assist them in combatting healthcare fraud. Many of the programs do not cover a lot of the fraud areas MRS identifies on a daily basis.

Insurance Companies

Insurance Companies

Medical Recovery Service (MRS) can greatly enhance the services Insurance companies offer to its insured members and businesses. Medical providers make it nearly impossible for insurance companies to scrutinize every hospital bill detailed itemized statement. Without a compliance review of a detailed itemized statement, thousands of non-billable charges go undetected.