Since providing our Overpayment Recovery Audits, HDM has identified significant financial savings opportunities for our clients with self-insured benefits. With our Overpayment Recovery Audit, HDM validates claim errors and identifies overpaid claims for clients — that oftentimes result from duplicate or similar claim overpayments, coordination of benefit errors, and provider posting errors — and provides the results to the administrator for recovery.

HDM takes additional steps to ensure full recovery for our clients. We work directly with providers to increase the recovery of payments for claims that a third-party has reimbursed. Additionally, HDM negotiates and monitors recovery collection activity to ensure all recovered dollars go to our client. By taking these steps and identifying these errors and cost savings, clients are also able to lower medical loss ratio, lessen provider appeals, and increase earnings per share.

The following are the steps in overpayment recovery audits:

Validation
HDM has developed analytical tools that identify claim errors and overpayments. HDM auditors perform onsite audits to validate findings.

HDM Involvement
HDM validates errors and overpayments, and present findings directly to the administrator and will negotiate with the administrator to resolve all findings.

Tracking Recoveries
HDM finalizes all audit findings with each administrator and tracks recoveries to ensure payments or offsets go to our customers.

To learn more about our cost containment solutions for self-insured employers, contact HDM today at 800.859.5119 or request information with our online form. You may also send an email to: info@HDMinc.com.