Intelligent Cost Containment
In Context’s experience up to 50% of claims are paid inaccurately. Results are dependent on the data science used to detect potential aberrations. This is where Context leapfrogs the competition. The same data scientists that drive intelligence for our UCR and coding systems build our payment integrity logic.
One customer ran post-adjudicated claims from their mainstream editing software through Context’s Payment Integrity Platform. We found that 70% of those claims still had aberrations. Had they been corrected prior to payment, the customer would have avoided $3 Million a month in errant payments.
Our real-time, cloud based Payment Integrity Platform provides comprehensive tools for cost containment including:
- Pricing leveraging UCR and all 16 Medicare Prospective Payment Systems to facilitate price negotiations, re-pricing and support your client’s position
- Advanced Medicare and Commercial analytics logic to assess payment compliance at a granular level
- FWA analytics and reporting at the member and provider levels