Start paying facility claims the right way, today.
Stop fraud, elevate accuracy and save money.
FacilityClaim Insight® is a prepayment fraud, abuse and overpayment prevention service. It’s designed to help you elevate claims payment accuracy, identify fraudulent providers and decrease facility claims costs. With our advanced Code Validator Pro® (rules-based), Fraud Finder Pro® (profiling) and claims re-pricing software systems, you get better technology. With our AHIMA-credentialed examiners, investigators and skilled negotiators, you get better results.
HCI customers using this service consistently realize facility claim savings of 15%-30% Darin Johnson, MBA HealthCare Insight
The Problem
An estimated 3% - 10% of the national outlay for facility care is lost to fraud, abuse and overpayments annually. By 2013, losses could exceed $99 billion. That's a loss of over $271 million daily.
The Solution
Pay Right. Save Money
Decrease targeted claim costs by up to 20% off payable charges, or $4 PMPM.
Get a Clinician. Get Results.
Our clinical validation process delivers less false positives and better results.
Save Time. Go Prepayment.
Avoid “pay and chase” detection with prepayment analysis on 100% of claims.
Smart Models. Smarter Software.
Get access to the most advanced fraud models and SaaS applications available.
Better Support. Better Service.
Get help from licensed nurses and coders. Get appeals support, reporting and more.
Total Customization. Totally You.
No two payors are alike. Customize your fraud solution down to the last bit and byte.
Real Fast, Rapid Processing.
You don’t have time to hold up processing. Get rapid protection with real results.
Fraud and Editing. All in One.
Unilke others, we bundle supplemental editing and fraud prevention in one solution.
View FCI Brochure
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